Cost-effectiveness of escitalopram vs. citalopram in major depressive disorder.

Abstract

Clinical trials have shown better efficacy of escitalopram over citalopram, and review-based economic models the cost-effectiveness of escitalopram vs. citalopram (brand and generic). No head-to-head clinical trial has, however, evaluated the cost-effectiveness of both drugs so far. The aim of this study was to assess the relative cost-effectiveness of escitalopram compared with citalopram in patients with major depressive disorder. An economic evaluation was conducted alongside a double-blind randomized clinical trial conducted by general practitioners and psychiatrists comparing fixed doses of escitalopram (20 mg/day) or citalopram (40 mg/day) over 8 weeks in ambulatory care patients with major depressive disorder (baseline Montgomery-Asberg Depression Rating Scale score > or =30). Resources use was recorded using a standardized form recording use of healthcare services and days of sick leave for the 2-month prestudy period and for the 8-week study period. Statistically significant improvements were observed in patients treated with escitalopram. Mean per-patient costs for the escitalopram group, compared with the citalopram group, were 41% lower (96 euro vs. 163 euro; P<0.05) from a healthcare perspective. Differences were mostly related to lower hospitalization costs for escitalopram compared with citalopram recipients, assuming a parity price between escitalopram and citalopram. Bootstrapped distributions of the cost-effectiveness ratios also showed better effectiveness and lower costs for escitalopram compared with citalopram. Escitalopram is significantly more effective than citalopram, and is associated with lower healthcare costs. This prospective economic analysis demonstrated that escitalopram is a cost-effective first-line treatment option for major depressive disorder.

• Authors: Bruno Fantino, Nicholas Moore, Hélène Verdoux, Jean-Paul Auray
• Journal: International clinical psychopharmacology (Int Clin Psychopharmacol) Vol. 22 Issue 2 Pg. 107-15 (Mar 2007) ISSN: 0268-1315 [Print] England
• PMID: 17293711 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Antidepressive Agents, Second-Generation
• Citalopram

Topics

• Adult
• Antidepressive Agents, Second-Generation (economics, therapeutic use)
• Citalopram (economics, therapeutic use)
• Cost-Benefit Analysis
• Depressive Disorder, Major (drug therapy)
• Drug Costs
• Drug Therapy (economics)
• Female
• France
• Health Care Costs
• Hospital Costs
• Humans
• Male
• Middle Aged
• Office Visits (economics)
• Psychiatric Status Rating Scales
• Randomized Controlled Trials as Topic
• Treatment Outcome