A cost-effectiveness model of escitalopram, citalopram,and venlafaxine as first-line treatment for major depressive disorder in Belgium

Efficacy and safety of escitalopram versus citalopram in major depressive disorder: a 6-week, multicenter, randomized, double-blind, flexible-dose study

“…In another randomized, double-blind, 24-week study, escitalopram 10 mg/d was not significantly more effective than citalopram 20 mg/d in long-term treatment (Colonna et al 2005). Compared with citalopram, escitalopram was associated with lower health care costs in some countries, particularly for the geriatric population (Demyttenaere et al 2005;Fantino et al 2007;Francois et al 2003;Wade et al 2005;Wu et al 2008).…”

Treatment of Major Depressive Disorder in Patients Failing Initial Therapy: An Excel-Based Pharmacoeconomic Model

“…Results from the Monte Carlo sensitivity analysis suggested that escitalopram was morec ost-effective than venlafaxine XR in approximately 61% of the cases. 31 This result appears to be due to differences in medication costs, with venlafaxine being slightly more expensive than escitalopram.…”

“…28,[30][31][32][33][34]70,71 These analyses do not consider the role of generic SSRIs, which are becoming more prominent with products going off patent. Those economic analyses that have included generic SSRIs assume first-line treatment of MDD.…”

“…reported on the costeffectiveness of citalopram, escitalopram, and venlafaxine using a2-stage model with a6-month time horizon. 31 The…”

“…Second-line pharmacologic treatment options include titrating the dose of the initial antidepressant, augmenting therapy with a second agent, or switching to another SSRI or an agent with a different mechanism of action, such as an SNRI. [28][29][30][31] The ARGOS study evaluated an SNRI, venlafaxine extended release XR, in patients who had failed to respond to or could not tolerate conventional antidepressants, primarily SSRIs, in a psychiatric outpatient setting. Those treated with venlafaxine XR had significantly higher remission rates (59.3%) at 24 weeks compared with those treated with conventional antidepressants (i.e., paroxetine, citalopram, sertraline, fluoxetine, mirtazapine, or other treatments) (51.5%; P <0.001).…”