C-QUALITY: Cost and Quality-of-Life Pharmacoeconomic Analysis of Antidepressants in Major Depressive Disorder in Italy

Mencacci, Claudio; Aguglia, Eugenio; Biggio, Giovanni; Cappellari, Lodovico; Sciascio, Guido Di; Fagiolini, Andrea; Maina, Giuseppe; Tortorella, Alfonso; Katz, Pablo; Ripellino, Claudio

doi:10.1007/s12325-013-0046-z

Cited by 5 publications

(4 citation statements)

References 23 publications

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“…Only three of the reviewed studies that included DTs explicitly reported validation methods. Two used expert panels to validate the data sources and one used individual panellists to verify the model estimates [ 35 – 37 ].…”

Section: Resultsmentioning

confidence: 99%

Model-Based Economic Evaluation of Treatments for Depression: A Systematic Literature Review

Kolovos

Bosmans

Riper

et al. 2017

PharmacoEconomics Open

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BackgroundAn increasing number of model-based studies that evaluate the cost effectiveness of treatments for depression are being published. These studies have different characteristics and use different simulation methods.ObjectiveWe aimed to systematically review model-based studies evaluating the cost effectiveness of treatments for depression and examine which modelling technique is most appropriate for simulating the natural course of depression.MethodsThe literature search was conducted in the databases PubMed, EMBASE and PsycInfo between 1 January 2002 and 1 October 2016. Studies were eligible if they used a health economic model with quality-adjusted life-years or disability-adjusted life-years as an outcome measure. Data related to various methodological characteristics were extracted from the included studies. The available modelling techniques were evaluated based on 11 predefined criteria.ResultsThis methodological review included 41 model-based studies, of which 21 used decision trees (DTs), 15 used cohort-based state-transition Markov models (CMMs), two used individual-based state-transition models (ISMs), and three used discrete-event simulation (DES) models. Just over half of the studies (54%) evaluated antidepressants compared with a control condition. The data sources, time horizons, cycle lengths, perspectives adopted and number of health states/events all varied widely between the included studies. DTs scored positively in four of the 11 criteria, CMMs in five, ISMs in six, and DES models in seven.ConclusionThere were substantial methodological differences between the studies. Since the individual history of each patient is important for the prognosis of depression, DES and ISM simulation methods may be more appropriate than the others for a pragmatic representation of the course of depression. However, direct comparisons between the available modelling techniques are necessary to yield firm conclusions.Electronic supplementary materialThe online version of this article (doi:10.1007/s41669-017-0014-7) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Model-Based Economic Evaluation of Treatments for Depression: A Systematic Literature Review

Kolovos

Bosmans

Riper

et al. 2017

PharmacoEconomics Open

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“…Nevertheless, since the Italian health care system decentralizes the administrative decisions at regional level, creating several pricelists for each region, applying a weighted mean to the regional data is a common way of estimating national cost data 22. Moreover, in this case, the mean costs have been varied by means of probability distributions, with a PSA, in order to account for uncertainty in the model.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis on the use of rFSH + rLH for the treatment of anovulation in hypogonadotropic hypogonadal women

Papaleo

Alviggi

Colombo

et al. 2014

TCRM

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BackgroundHypogonadotropic hypogonadal women are characterized by ovarian functionality deficiency, caused by low concentrations of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). To recover reproduction functionality, recommended therapies for ovarian induction involve injections of FSH and LH medications.ObjectiveSince important differences exist between recombinant and urinary gonadotropin therapies in terms of efficacy and cost, the objective of this study was to develop a cost-effectiveness model to compare recombinant FSH (rFSH) + recombinant LH (rLH) and highly purified human menopausal gonadotropin (HP-HMG).MethodsA Markov model was developed, considering three cycles of therapy; probability of pregnancy and miscarriage were considered, and the efficacy was evaluated in terms of pregnancy occurrence. The perspective of the model was that of the Italian Health Service, so only direct cost (drugs, specialist visits, patient examinations, and hospitalizations) were included.ResultsrFSH + rLH is associated with a higher total cost (€3,453.50) and higher efficacy (0.87) compared with HP-HMG (€2,719.70 and 0.50). rFSH + rLH generated an incremental cost effectiveness ratio equal to €2,007.30 compared to HP-HMG; the average cost per pregnancy is estimated to be €3,990.00 for recombinant strategy and €5,439.80 for urinary strategy. Results of probabilistic sensitivity analysis were consistent with the abovementioned findings.ConclusionDespite the higher acquisition cost in comparison to HP-HMG, rFSH + rLH resulted in a higher pregnancy rate, which makes it the recommended choice when considering cost-effectiveness of LH in supporting FSH-induced follicular gonadotropins in hypogonadotropic hypogonadal women.

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“…In this study, the DDC of escitalopram ranked fourth among antidepressants, but the high daily cost did not lessen the enthusiasm of patients. A cost and quality-of-life pharmacoeconomic analysis has also suggested that escitalopram, despite its tremendous cost, is preferred to other antidepressants as the most cost-effective pharmacological treatment strategy (9).…”

Section: Discussionmentioning

confidence: 99%

“…Drug utilization research has extensively been conducted to evaluate drug use in China, and a DDD as well as the daily drug cost (DDC) are popular concepts adopted in most drug utilization researches (8). Since patients with clinical depression require long-term treatment, it is important to take into account not only safety, tolerance, and therapeutic effects, but also costs of a drug (9). The DDC gives information about the average daily cost of a certain drug.…”

Section: Methodsmentioning

confidence: 99%

Increased Use of Antidepressants in Wuhan, China: a Retrospective Study From 2006 to 2012

Gao

Zhang

et al. 2014

Medicina

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Objective. The aim of this study was to investigate the trend of antidepressant use and analyze the daily cost of antidepressants in Wuhan, China. Material and Methods. The data on the expenditure of antidepressants in Wuhan from 2006 to 2012 were retrospectively analyzed based on the defined daily dose (DDD) method recommended by the World Health Organization. In addition, the daily cost of antidepressants was calculated for the pharmacoeconomic evaluation. Results. The overall sales of antidepressants increased by 566.7% over the 7-year period. The utilization of antidepressants increased annually from 1.067 DDDs per 1000 inhabitants per day in 2006 to 4.144 in 2012. This upward trend was mainly driven by an increase in the use of selective serotonin reuptake inhibitors (SSRIs), which accounted for about 60% of antidepressant use. Notably, the use of traditional Chinese patent medicines (TCMs) approved to treat depression in China in 2010 increased from 0.158 DDDs per 1000 inhabitants per day in 2010 to 0.305 in 2012. The daily drug cost analysis indicated that selective serotonin and norepinephrine reuptake inhibitors (SNRIs) and other new antidepressants were more expensive while tricyclic and tetracyclic antidepressants (TCAs) had a low-cost advantage. Conclusions. Antidepressants were increasingly used over the study period. Among them, SSRIs followed by SNRIs were the most commonly used. After the approval for the treatment of depression, TCMs were generally accepted by physicians and patients. The low-cost advantage allowed TCAs to be used in the antidepressant therapy.

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C-QUALITY: Cost and Quality-of-Life Pharmacoeconomic Analysis of Antidepressants in Major Depressive Disorder in Italy

Abstract: The results indicate that escitalopram is the most cost-effective pharmacological treatment strategy for the Italian health service compared with other SSRIs and all SNRIs used in the first-line treatment of MDD.

Cited by 5 publications

References 23 publications

Model-Based Economic Evaluation of Treatments for Depression: A Systematic Literature Review

Model-Based Economic Evaluation of Treatments for Depression: A Systematic Literature Review

Cost-effectiveness analysis on the use of rFSH + rLH for the treatment of anovulation in hypogonadotropic hypogonadal women

Increased Use of Antidepressants in Wuhan, China: a Retrospective Study From 2006 to 2012

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