TY - JOUR
KW - Antidepressive Agents, Second-Generation/economics/therapeutic use
KW - Citalopram/economics/therapeutic use
KW - Cost-Benefit Analysis/methods/statistics & numerical data
KW - Cyclohexanols/economics/therapeutic use
KW - Decision Support Techniques
KW - Denmark
KW - Depressive Disorder, Major/drug therapy/economics
KW - Drug Costs/statistics & numerical data
KW - Humans
KW - Models, Economic
KW - Physician's Practice Patterns/statistics & numerical data
KW - Primary Health Care/economics/methods
KW - Remission Induction/methods
AU - J. Sorensen
AU - K. B. Stage
AU - N. Damsbo
AU - A. Le Lay
AU - M. E. Hemels
A1 - 
AB - The objective of this study was to model the cost-effectiveness of escitalopram in comparison with generic citalopram and venlafaxine in primary care treatment of major depressive disorder (baseline scores 22-40 on the Montgomery-Asberg Depression Rating Scale, MADRS) in Denmark. A three-path decision analytic model with a 6-month horizon was used. All patients started at the primary care path and were referred to outpatient or inpatient secondary care in the case of insufficient response to treatment. Model inputs included drug-specific probabilities derived from systematic literature review, ad-hoc survey and expert opinion. Main outcome measures were remission defined as MADRS < or = 12 and treatment costs. Analyses were conducted from healthcare system and societal perspectives. The human capital approach was used to estimate societal cost of lost productivity. Costs were reported in 2004 DDK. The expected overall 6-month remission rate was higher for escitalopram (64.1%) than citalopram (58.9%). From both perspectives, the total expected cost per successfully treated patient was lower for escitalopram (DKK 22,323 healthcare, DKK 72,399 societal) than for citalopram (DKK 25,778 healthcare, DKK 87,786 societal). Remission rates and costs were similar for escitalopram and venlafaxine. Robustness of the findings was verified in multivariate sensitivity analyses. For patients in primary care, escitalopram appears to be a cost-effective alternative to (generic) citalopram, with greater clinical benefit and cost-savings, and similar in cost-effectiveness to venlafaxine.
BT - Nordic journal of psychiatry
C5 - Financing & Sustainability
CP - 2
CY - Norway
DO - 10.1080/08039480701226070
IS - 2
JF - Nordic journal of psychiatry
N2 - The objective of this study was to model the cost-effectiveness of escitalopram in comparison with generic citalopram and venlafaxine in primary care treatment of major depressive disorder (baseline scores 22-40 on the Montgomery-Asberg Depression Rating Scale, MADRS) in Denmark. A three-path decision analytic model with a 6-month horizon was used. All patients started at the primary care path and were referred to outpatient or inpatient secondary care in the case of insufficient response to treatment. Model inputs included drug-specific probabilities derived from systematic literature review, ad-hoc survey and expert opinion. Main outcome measures were remission defined as MADRS < or = 12 and treatment costs. Analyses were conducted from healthcare system and societal perspectives. The human capital approach was used to estimate societal cost of lost productivity. Costs were reported in 2004 DDK. The expected overall 6-month remission rate was higher for escitalopram (64.1%) than citalopram (58.9%). From both perspectives, the total expected cost per successfully treated patient was lower for escitalopram (DKK 22,323 healthcare, DKK 72,399 societal) than for citalopram (DKK 25,778 healthcare, DKK 87,786 societal). Remission rates and costs were similar for escitalopram and venlafaxine. Robustness of the findings was verified in multivariate sensitivity analyses. For patients in primary care, escitalopram appears to be a cost-effective alternative to (generic) citalopram, with greater clinical benefit and cost-savings, and similar in cost-effectiveness to venlafaxine.
PP - Norway
PY - 2007
SN - 0803-9488; 0803-9488
SP - 100
EP - 108
EP - 
T1 - A Danish cost-effectiveness model of escitalopram in comparison with citalopram and venlafaxine as first-line treatments for major depressive disorder in primary care
T2 - Nordic journal of psychiatry
TI - A Danish cost-effectiveness model of escitalopram in comparison with citalopram and venlafaxine as first-line treatments for major depressive disorder in primary care
U1 - Financing & Sustainability
U2 - 17454724
U3 - 10.1080/08039480701226070
VL - 61
VO - 0803-9488; 0803-9488
Y1 - 2007
ER -