Podcast episode examines the cost of treatment-resistant depression

A new Health Policy Podcast episode looks at how treatment-resistant depression raises Medicare spending, delays care and worsens outcomes for patients. The discussion features policy expert Mark Desmarais and Dr. William Sauvé and points to earlier access and fewer administrative barriers as key fixes.

Why it matters: - Treatment-resistant depression drives higher healthcare use and higher Medicare costs. - The episode frames TRD as both a clinical problem and a policy problem, with consequences for patients, providers and the broader health system. - The discussion points to delays in care as a factor that can worsen illness and increase the chance of hospitalization.

What happened: - The Health Policy Podcast released a new episode on treatment-resistant depression on June 23, 2026. - The episode features Mark Desmarais, a principal at Health Management Associates, and Dr. William Sauvé, chief medical officer at Osmind. - The conversation focuses on the human and economic toll of TRD and the policy changes needed to improve care access.

The details: - Desmarais discussed findings from a recent analysis of Medicare beneficiaries with treatment-resistant depression. - The analysis found that people living with TRD incur about $8,000 more in annual healthcare costs than patients whose depression is effectively managed. - Desmarais said TRD patients use more healthcare services, including hospital visits and medications. - Sauvé said TRD is generally defined as depression that does not respond to at least two medication treatments. - Sauvé said many patients spend years trying unsuccessful treatments before finding relief. - Sauvé said patients with TRD can live with decades of chronic illness, which can worsen the condition and contribute to additional health complications. - The episode also examined broader mental health system pressures, including rising demand for psychiatric care, provider shortages and administrative barriers. - Sauvé said prior authorization is a major obstacle for patients seeking advanced therapies. - Sauvé said prior authorization can take weeks to resolve, during which patients may continue to deteriorate and face hospitalization. - The full episode, “The Human and Economic Toll of Treatment-Resistant Depression,” is available at HealthPolicyPodcast.com and through major podcast platforms.

Between the lines: - The episode links delayed treatment with higher downstream costs, suggesting faster access to effective care could reduce both suffering and spending. - The Medicare angle makes the issue especially relevant for policymakers because cost growth affects a large public program, not just individual patients. - The focus on prior authorization signals that administrative friction may be a practical target for reform, not just a clinical one.

What's next: - Desmarais said policymakers should create pathways that make effective TRD treatments easier to access. - The episode suggests future policy debates will likely center on earlier intervention, coverage design and reducing treatment delays. - Health system stakeholders, including clinicians and patient advocates, are positioned to use the discussion as a case for behavioral health access reforms.