Researchers found that using a systematic approach for the treatment of depression in diabetics will not increase health care spending, and might actually decrease the overall costs.

Researchers evaluated the cost and cost-effectiveness of a systematic depression treatment program versus the usual care for 329 outpatients with diabetes and depression. The intervention involved specialized nurses who provided a 12-month stepped-care depression treatment program using psychotherapy or antidepressant drugs or both. Systematic depression treatment significantly reduced the patients' average depression scores after 6 and 12 months, and these improvements were maintained at 24 months.

Outpatient depression treatment costs were approximately $700 higher in the intervention group during the first year, the results indicate. However the general medical outpatient costs in this group were lower, and offset most of the difference. During the second year, the approximately $100 in higher outpatient depression treatment costs in the intervention group was more than offset by lower outpatient costs of approximately $1400.

The study was designed with the hope of alleviating human suffering caused by diabetes. If reducing the burden of suffering also reduces costs of care, then depression management programs should be routinely integrated into diabetes care. Preempt this mission with the fact that the systematic depression treatment programs were associated with an increase of 61 depression-free days and an estimated cost savings of $300 - that's a monthly stipend of 20% more Happy Days and a half tank of gas. That'll give you something to smile about!