CLINICAL AND ECONOMIC COMPARISON OF SERTRALINE AND FLUOXETINE IN THE TREATMENT OF DEPRESSION - A 6-MONTH DOUBLE-BLIND-STUDY IN A PRIMARY-CARE SETTING IN FRANCE

In a double-blind study in a primary-care setting in France, outpatien ts fulfilling DSM IV criteria for a major depressive episode were rand omised to receive sertraline (50 to 150 mg/day; n = 122) or fluoxetine (20 to 60 mg/day; n = 120). Assessments, including clinical evaluatio n [Montgomery-Asberg Depression Rating Scale (MADRS), Clinical Global Impressions (CGI)] and quality of life [Functional Status Questionnair e (FSQ)], were made at study entry and after 4 and 6 months of treatme nt. Use of medical services, absences from work and productivity losse s were recorded for calculation of direct and indirect costs from both the overall societal perspective and in terms of sickness insurance. In total, 231 patients (116 receiving sertraline, 115 receiving fluoxe tine) were included in an intention-to-treat analysis assessed up to t he last visit. Statistically significant clinical and quality-of-life improvements from baseline were observed in both treatment groups, wit h no between-group differences. Utilisation of medical resources was h igher in fluoxetine-treated patients, with significantly more consulta tions with specialists. The 2 treatment groups were similar in terms o f number of hospitalisations and duration of stay, whether related to depression or not. There were no significant differences between group s for work or productivity losses. Cost comparisons favoured sertralin e treatment from both the societal (FF7780 vs FF8706) and sickness ins urance (FF2936 vs FF3224) viewpoints, with cost differentials of FF926 and FF288, respectively. From the societal perspective, the total cos t per patient over the 6-month course of the trial, irrespective of th e study treatment given, was FF8241, and the corresponding sickness in surance cost was FF3079. At the time of the study, FF1 = $US0.1993.