Escitalopram and duloxetine in major depressive disorder: a pharmacoeconomic comparison using UK cost data

Escitalopram and duloxetine in major depressive disorder: a pharmacoeconomic comparison using UK cost data

2008 Pharmacoeconomics

Wade, A. G. | Fernandez, J. L. | Francois, C. | Hansen, K. | Danchenko, N. | Despiegel, N. | Volume: 26, Issue: 11, Pages: 969-81, Absenteeism, Adolescent, Adult, Antidepressive Agents/*economics/therapeutic use, Antidepressive Agents, Second-Generation/economics/therapeutic use, Citalopram/*economics/therapeutic use, Cost-Benefit Analysis, Depressive Disorder, Major/drug therapy/*economics, Double-Blind Method, Duloxetine Hydrochloride, Female, Humans, Male, Middle Aged, Multivariate Analysis, Severity of Illness Index, Sick Leave/economics, Surveys and Questionnaires, Thiophenes/*economics/therapeutic use, United Kingdom/epidemiology, Young Adult,

BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs) are approved for the treatment of major depressive disorder (MDD). The allosteric SSRI escitalopram has been shown to be at least as clinically effective as the SNRIs venlafaxine and duloxetine in MDD, with a better tolerability profile. In addition, escitalopram has been shown to be cost saving compared with venlafaxine. OBJECTIVE: To evaluate the cost effectiveness of escitalopram versus duloxetine in the treatment of MDD, and to identify key cost drivers. METHODS: The pharmacoeconomic evaluation was conducted alongside a 24-week, double-blind, multinational randomized study (escitalopram 20 mg/day and duloxetine 60 mg/day) in outpatients with MDD, aged 18-65 years, with Montgomery-Asberg Depression Rating Scale (MADRS) score >or=26 and Clinical Global Impression Severity (CGI-S) score >or=4, and baseline duration of the current depressive episode of 12 weeks to 1 year.The analysis was conducted on the full analysis set (FAS), which included all patients with >or=1 valid post-baseline health economic assessment. Effectiveness outcomes of the cost-effectiveness analyses (CEA) included the change in Sheehan Disability Scale (SDS) score (primary CEA), treatment response (MADRS score decrease >or=50%) and remission (MADRS score