Three studies effectively demonstrate the difference in medical costs between depressed workers and those who are not depressed:

Birnbaum HG, Greenberg PE, Barton M, Kessler RC, Rowland CR, Williamson TE (1999). Workplace burden of depression: A case study in social functioning using employer claims data. Drug Benefit Trends, 11(8):6.
Using claims data from a Fortune 100 manufacturer, the direct and indirect costs of depression were compiled for 4,220 patients with one or more medical claims in 1997 for major depression (MD). Total medical, pharmaceutical, and disability costs were 4.2 times higher for MD patients than the typical beneficiary ($8,709 vs. $2,059). MD patients with depression disability claims had an average yearly cost of $13,929.

Simon GE, Revicki D, Heiligenstein J, Grothaus L, VonKorff M, Katon WJ, Hylan TR, (2000). Recovery from depression, work productivity, and health care costs among primary care patients. General Hospital Psychiatry, 22, 153-62.
This study examined 290 adults with major depression who were beginning antidepressant treatment. Patients who had improved or remitted after 12 months reported fewer days missed from work due to illness (10.4 and 6.3 in two years) compared to patients who had not improved (16.8). Patients who were improved or remitted after 12 months had lower health care costs during the second year of follow-up ($2,345 and $2,236) compared to patients who had not improved ($6,365). The authors conclude that recovery from depression is related to significant reductions in work disability and possibly related to reductions in health care costs.

Goetzel RZ, Anderson DR, Whitmer RW, Ozminkowski RJ, Dunn RL, Wasserman J, HERO Research Committee (1998). The relationship between modifiable health risks and health care expenditures. Journal of Occupational and Environmental Medicine, 40(10), 843-854.
The authors used retrospective analysis of 46,026 employees from six large health care purchasers for up to three years after they had completed an initial health risk appraisal. The appraisal classified employees into either High Risk or Low Risk for depression. Only 2.2% of the sample was considered High Risk. The High Risk group had average annual medical expenditures of $3,189 compared to $1,679 for the Low Risk group.

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