COST-UTILITY ANALYSIS EVALUATING VORTIOXETINE VERSUS VENLAFAXINE XR AND AGOMELATINE IN THE TREATMENT OF MAJOR DEPRESSIVE DISORDER IN TAIWAN
Author(s)
Brignone M1, Atsou K1, Reynaud-Mougin C2, Chen W3, Milea D4
1Lundbeck SAS, Paris, France, 2H. Lundbeck A/S, Copenhagen, Denmark, 3Hoan Pharmaceuticals Ltd., Taipei, Taiwan, 4Lundbeck Singapore Pte Ltd, Singapore, Singapore
OBJECTIVES: Taiwan has established a process for drug reimbursement wherein economic evaluation is becoming important. Several antidepressants are marketed in Taiwan and although effective, they do not fully meet the needs of all patients with major depressive disorders (MDD) We assessed the cost-utility of vortioxetine (a novel antidepressant) versus the other antidepressants, venlafaxine XR and agomelatine, included in head-to-head clinical studies in MDD. METHODS: One-year cost-utility analyses from both the payer and societal perspectives were performed using an initial decision-tree model, followed by a Markov model for subsequent treatments lines. Remission, relapse and recovery were the main health-states. Efficacy at two months was derived from the Asian SOLUTION (NCT01571453) study for vortioxetine versus venlafaxine XR and the REVIVE (NCT01488071) study for vortioxetine versusagomelatine. STAR*D was the source for the effectiveness of subsequent treatment lines. Adverse event were included to evaluate their impact on quality of life and costs. Utilities were derived from REVIVE and adverse event dis-utilities from the literature. Resource use and productivity were obtained from an analysis of the Taiwan National Health Insurance database and a physician survey. Taiwan 2015 costs were applied. Probabilistic sensitivity analyses were conducted. RESULTS: Vortioxetine was the dominant strategy compared to both comparators over one year: it induced additional QALY gains (0.01 and 0.02) and was cheaper whether including productivity costs or not (Direct cost savings: NT$9,019 and NT$12,245; Societal: NT$11,726 and NT$15,600) compared to venlafaxine XR and agomelatine respectively. These results were confirmed to be robust through sensitivity analyses; vortioxetine remained dominant in 97% of probabilistic simulations. CONCLUSIONS: In summary, the cost-utility analyses demonstrated that vortioxetine would be a relevant alternative therapeutic option in a MDD population in Taiwan compared to venlafaxine XR and agomelatine as it was more effective and cost saving.
Conference/Value in Health Info
2016-09, ISPOR Asia Pacific 2016, Singapore
Value in Health, Vol. 19, No. 7 (November 2016)
Code
PMH14
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Mental Health