Budget Impact Analysis of Vortioxetine for Major Depressive Disorder Treatment Within China's National Health Insurance System
Author(s)
Marie Wu, Master of Health Sciences.
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
OBJECTIVES: With over 95 million people affected by depression in China, the economic burden on the National Health Insurance System is substantial. Vortioxetine, recently approved and included in China's National Reimbursement Drug List (NRDL), offers potential clinical advantages but at higher acquisition costs. This study evaluated the budget impact of vortioxetine adoption within China's medical insurance framework perspective.
METHODS: We developed a budget impact model from the perspective of China's National Healthcare Security Administration (NHSA) over a 5-year horizon (2025-2029). The analysis included Urban Employee Basic Medical Insurance (UEBMI), Urban Resident Basic Medical Insurance (URBMI), and New Rural Cooperative Medical System populations. Target population comprised moderate-to-severe MDD patients eligible for second-line treatment. Market uptake scenarios modeled vortioxetine achieving 5%, 10%, and 15% market share, displacing current standard treatments (sertraline, escitalopram, venlafaxine). Direct medical costs included drug acquisition, physician visits, hospitalizations, and adverse event management. Indirect costs encompassed productivity losses and disability payments. Unit costs were derived from national tender prices, DRG payment standards, and published Chinese health economic studies.
RESULTS: The target population was estimated at 4.2 million patients nationally. At 10% market share, vortioxetine adoption would increase annual antidepressant expenditure by ¥892 million (0.08% of total mental health budget). However, reduced hospitalization rates (-12%), emergency visits (-18%), and sick leave days (-25%) generated offsetting savings of ¥567 million annually. Net budget impact was ¥325 million increase in Year 1, declining to ¥156 million by Year 5 due to improved treatment outcomes and reduced long-term care needs. Sensitivity analyses showed results were robust to ±20% variations in drug costs and clinical parameters.
CONCLUSIONS: Vortioxetine introduction represents a manageable budget impact for China's health insurance system, with short-term expenditure increases largely offset by medium-term healthcare savings. The analysis supports sustainable financing of innovative depression treatments while maintaining system affordability.
METHODS: We developed a budget impact model from the perspective of China's National Healthcare Security Administration (NHSA) over a 5-year horizon (2025-2029). The analysis included Urban Employee Basic Medical Insurance (UEBMI), Urban Resident Basic Medical Insurance (URBMI), and New Rural Cooperative Medical System populations. Target population comprised moderate-to-severe MDD patients eligible for second-line treatment. Market uptake scenarios modeled vortioxetine achieving 5%, 10%, and 15% market share, displacing current standard treatments (sertraline, escitalopram, venlafaxine). Direct medical costs included drug acquisition, physician visits, hospitalizations, and adverse event management. Indirect costs encompassed productivity losses and disability payments. Unit costs were derived from national tender prices, DRG payment standards, and published Chinese health economic studies.
RESULTS: The target population was estimated at 4.2 million patients nationally. At 10% market share, vortioxetine adoption would increase annual antidepressant expenditure by ¥892 million (0.08% of total mental health budget). However, reduced hospitalization rates (-12%), emergency visits (-18%), and sick leave days (-25%) generated offsetting savings of ¥567 million annually. Net budget impact was ¥325 million increase in Year 1, declining to ¥156 million by Year 5 due to improved treatment outcomes and reduced long-term care needs. Sensitivity analyses showed results were robust to ±20% variations in drug costs and clinical parameters.
CONCLUSIONS: Vortioxetine introduction represents a manageable budget impact for China's health insurance system, with short-term expenditure increases largely offset by medium-term healthcare savings. The analysis supports sustainable financing of innovative depression treatments while maintaining system affordability.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE101
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
Mental Health (including addition)