[PMH8] Pharmacoeconomic modelling in depression: aid or trap

[PMH8] Pharmacoeconomic modelling in depression: aid or trap

2000 Value in health

Toumi, M. | Francois, C. | Hansen, K. | Volume: 3, Issue: 5, Pages: 346, D,

OBJECTIVE: Pharmacoeconomic evaluation of selective
serotonin reuptake inhibitors (SSRIs) is becoming an important
issue for regulatory and marketing purposes. At
the time of the launch of the drug, decision-tree models
(i.e. Markov and Monte-Carlo) provide the most realistic
projection data available. Designed to provide a large
range of information on outcome and cost, which are
based on various assumptions, the models enable decision-makers
(physician, pharmacist, HMO, regulatory
etc.) to make informed, relative decisions. METHODS:
This poster illustrates five different model structures of
associated expenses that are incurred during the treatment
of Depression. The branches on these models become
progressively complex, and are based on the following
five factors: (1) severity of the depression, (2) rate
of compliance, (3) success/failure rate, (4) patient dropout
from the health care system (patient having no contact
with any medical institution or any medical doctor),
and (5) switch in case of failure or non tolerability. Costs
were taken from the literature using different sources.
RESULTS: SSRIs could be more or less cost-effective
than tricyclic antidepressants (TCAs) depending on whether
switch, compliance, success of treatment, dropout from
the health care system and disease have been taken into
consideration. Conversely, when the same information is
derived from different sources of the same country, the
cost-effectiveness ratio is significantly affected. Moreover,
sensitivity analysis does not prevent such differences
in outcome. CONCLUSIONS: Caution should be
used when reviewing such data as these results indicate
the tendency for gross discrepancy to exist between different
methods of analysis. These results thus emphasize
the need for standardized pharmacoeconomic models.
The authors make arguments in support of this endeavor.