Pharmacoeconomic analysis of antidepressants for major depressive disorderin the United Kingdom

Citation
H. Freeman et al., Pharmacoeconomic analysis of antidepressants for major depressive disorderin the United Kingdom, PHARMACOECO, 18(2), 2000, pp. 143-148
Citations number
10
Categorie Soggetti
Pharmacology
Journal title
PHARMACOECONOMICS
ISSN journal
11707690 → ACNP
Volume
18
Issue
2
Year of publication
2000
Pages
143 - 148
Database
ISI
SICI code
1170-7690(200008)18:2<143:PAOAFM>2.0.ZU;2-E
Abstract
Objective: To estimate the cost effectiveness of different classes of antid epressants in the UK National Health Service. Design, patients and interventions: The use of the serotonin (5-hydroxyhypt amine; 5-HT) and noradrenaline (norepinephrine) reuptake inhibitor (SNRI) v enlafaxine was compared with that of selective serotonin reuptake inhibitor s (SSRIs) and tricyclic antidepressants (TCAs) in patients with major depre ssive disorder (MDD). A meta-analysis determined the clinical success rate, and a decision tree was constructed by interviewing general practitioners and psychiatrists. Adding pharmacological and nonpharmacological treatment costs, meta-analytic rates were applied to the decision tree to calculate t he expected cost and outcome for each drug. Cost effectiveness was determin ed using a composite measure of outcome [symptom-free days (SFD)]. Main outcome measures and results: The meta-analysis included data from 44 studies on 4033 patients. The highest overall efficacy rate for outpatients with MDD was with venlafaxine use (73.7%), compared with 61.4% for SSRIs a nd 59.3% for TCAs. Treatment with venlafaxine yielded the lowest outpatient cost for a SFD (pound 10.53), compared with pound 13.23 for SSRIs and poun d 15.52 for TCAs (1998 values). Conclusions: Using this economic model, venlafaxine appears to be a cost-ef fective treatment for outpatients with MDD in the UK.