Skip to main content

Table 4 Cost of depression based on screening instrument PHQ-9 cut-off score ≥ 10

From: Adult depression screening in Saudi primary care: prevalence, instrument and cost

Direct cost Rating basis Unit cost (SAR) Patients/1000* Total (SAR) Comment
PHC screening Once/year 10 1,000 10,000 Use of PHQ-9 by nurse
GP visits 4 visits/year 100 90 36,000 45% needing treatment (90/200)
Specialist visits 8 visits/year 300 10 24,000 5% referred to psychiatrist (10/200)
Medication Full year 200/month 90 216,000 45% on meds (90/200)
Hospitalization 11 days/year 1,500/day 2 33,000 1% hospitalized (2/200)
Total     319,000 $85,067*
Indirect cost Rating basis Unit cost (SAR) Patients/1000 Total (SAR) Comment
Suicide Diyya 2011 350,000/life 2 700,000 Human life valued by ‘Blood Money’ rate
Absenteeism 20 days/year 8,000/month 30 240,000 20 work days equivalent to 1 month for 30/90 patients
Presenteeism 11 days/year 8,000/month 30 120,000 Average monthly salary in SA for 1/3 (30/90 patients)
Homemaker 20 days/year 4,000/month 30 120,000 Housemaid + babysitter + cook = Salary (30/90)
Care-giver 10 days/year 4,000/month 60 120,000 Conservative loss of care giver days
Total     1,300,000 $346,667
Grand total     1,619,000 $431,733
Sensitivity analysis     
Cost differential 20% Untreated-Treated 323,800 $86,347
Saving/person     324 For 1,000 adults screened in PHC = $86
Decreasing indirect cost & direct cost by 50%   490,500 650,000- 159,000 = ½ million SAR
Saving/person     500 For 1,000 adults screened in PHC = $133
  1. *20% patients with score  10, categorized as ‘depressed’ in the study (200/1000). **$1 = 3.75SAR.