Introduction of escitalopram, a new SSRI in Finland: comparison of cost-effectiveness between the other SSRIs and SNRI for the treatment of depression and estimation of the budgetary impact

Summary

A cost-effectiveness study of major depressive disorder was undertaken to compare escitalopram, a new SSRI, with citalopram, fluoxetine, and venlafaxine in Finland. A decision-tree model with a 6-month horizon was constructed using probabilities issued from comparative trial data, a standardised literature review and an expert panel. The therapeutic success (remission) and the treatment costs were the main outcomes. The expected success rate was 51.4% for escitalopram, 45.6% for citalopram, 45.6% for fluoxetine, and 49.6% for venlafaxine. Average expected total costs per patient are similar for escitalopram (EUR 857) and venlafaxine (EUR 876), and higher for citalopram (EUR 990) and fluoxetine (EUR 959). The budgetary impact shows a decrease in the total healthcare budget estimated at EUR 11.7 million. Escitalopram is a more cost-effective treatment than citalopram, fluoxetine, and venlafaxine in the treatment of depression and its increased utilisation would reduce healthcare costs for the treatment of depression in Finland.

Key words: :

• depression
• escitalopram
• models
• economic
• pharmacoeconomic analysis