OBJECTIVES: Major depressive disorder (MDD) is associated with increased healthcare resources utilization, reduced quality-of-life, and substantial indirect costs. In the Kingdom of Saudi Arabia (KSA), there is a paucity of national-level data for MDD prevalence. A study reported a prevalence rate of 12% in the south-eastern region of the KSA. Vortioxetine and Sertraline have shown promising clinical results in MDD patients. However, these drugs are not yet included in the Ministry of Health (MoH) formulary of the KSA. This study assessed the budgetary impact (BI) of introducing vortioxetine and/or sertraline in the MoH formulary for the management of MDD patients.

METHODS: A BI model was developed to assess different scenarios — introducing Vortioxetine and/or Sertraline as first-line and/or second-line therapy, over a five-year time horizon. The key model inputs included the estimated number of MDD patients treated in MoH facilities, antidepressants market shares, escalation probability, adverse event rates and cost, treatment costs, and monitoring cost. Inputs were retrieved from literature and validated by key-experts through face-to-face interviews.

RESULTS: The study demonstrated that the introduction of “only sertraline as first-line therapy” and “only vortioxetine as second-line” therapy increased the overall budget by 6.5% (SAR 15.9 million) and 8.9% (SAR 21.7 million), respectively compared to the status-quo. Introduction of “both sertraline as first-line and vortioxetine as second-line”, and “only vortioxetine as first-line” therapy resulted in a budget increase of 60.6% (SAR 147.3 million) and 72.7% (SAR 176.8 million), respectively compared to the status-quo.

CONCLUSIONS:

The introduction of sertraline and/or vortioxetine for the management of MDD patients in the KSA could overall increase the MoH budget. The increase in the budget would likely be lower with the introduction of “sertraline as first-line therapy” or “vortioxetine as second-line” therapy compared to introduction of “both vortioxetine first-line and sertraline second-line” and “vortioxetine as first-line” therapy.