Cost-Effectiveness Evaluation in Sweden of Escitalopram Compared with Venlafaxine Extended-Release as First-Line Treatment in Major Depressive Disorder

Mar 1, 2012, 00:00
10.1016/j.jval.2011.09.011
https://www.valueinhealthjournal.com/article/S1098-3015(11)03537-6/fulltext
Title : Cost-Effectiveness Evaluation in Sweden of Escitalopram Compared with Venlafaxine Extended-Release as First-Line Treatment in Major Depressive Disorder
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(11)03537-6&doi=10.1016/j.jval.2011.09.011
First page : 231
Section Title : Economic Evaluation
Open access? : No
Section Order : 2

Objectives

Major depressive disorder (MDD) is a major public health concern associated with a high burden to society, the health-care system, and patients and an estimated cost of €3.5 billion in Sweden. The objective of this study was to assess the cost-effectiveness of escitalopram versus generic venlafaxine extended-release (XR) in MDD, accounting for the full clinical profile of each, adopting the Swedish societal perspective, and identifying major cost drivers.

Methods

Cost-effectiveness of escitalopram versus venlafaxine XR was analyzed over a 6-month time frame, on the basis of a decision tree, for patients with MDD seeking primary care treatment in Sweden. Effectiveness outcomes for the model were quality-adjusted life-years and probability of sustained remission after acute treatment (first 8 weeks) and sustained for 6 months. Cost outcomes included direct treatment costs and indirect costs associated with sick leave.

Results

Compared with generic venlafaxine XR, escitalopram was less costly and more effective in terms of quality-adjusted life-years (expected gain 0.00865) and expected 6-month sustained remission probability (incremental gain 0.0374). The better tolerability profile of escitalopram contributed to higher expected quality-adjusted life-years and lower health-care resource utilization in terms of pharmacological treatment of adverse events (though only a minor component of treatment costs). Expected per-patient saving was €169.15 for escitalopram versus venlafaxine. Cost from sick leave constituted about 85% of total costs.

Conclusions

Escitalopram was estimated as more effective and cost saving than generic venlafaxine XR in first-line MDD treatment in Sweden, driven by the effectiveness and tolerability advantages of escitalopram. The study findings are robust and in line with similar pharmacoeconomic analyses.

Categories :
  • Cost-comparison, Effectiveness, Utility, Benefit Analysis
  • Economic Evaluation
  • Mental Health
  • Specific Diseases & Conditions
Tags :
  • cost-effectiveness
  • first-line therapy
  • major depressive disorder (MDD)
  • remission
  • selective norepinephrine reuptake inhibitor (SNRI)
  • selective serotonin reuptake inhibitor (SSRI)
Regions :
  • Africa
  • Eastern and Central Europe
  • Middle East
  • Western Europe
ViH Article Tags :