Successfully treated patients with vortioxetine versus venlafaxine: a simplified cost-effectiveness analysis based on a head-to-head study in Asian patients with major depressive disorder

Abstract

Objective: To compare the rates of successfully treated patients (STPs) with vortioxetine versus venlafaxine in major depressive disorder (MDD), using dual endpoints that combine improvement of mood symptoms with optimal tolerability or functional remission, and conduct a simplified cost-effectiveness analysis.

Methods: The 8-week SOLUTION study (NCT01571453) assessed the efficacy and safety of vortioxetine (10 mg/day) versus venlafaxine XR (150 mg/day) in adult Asian patients with MDD. Rates were calculated post-hoc of STP Mood and Tolerability (≥50% reduction from baseline in Montgomery–Åsberg Depression Rating Scale [MADRS] total score and no treatment-emergent adverse events) and STP Mood and Functioning (≥50% reduction from baseline in MADRS total score and Sheehan Disability Scale total score ≤6). The incremental costs per STP were assessed using the 2018 pharmacy purchase prices for branded vortioxetine/branded venlafaxine in China as the base case.

Results: STP Mood and Tolerability rates were 28.9% for vortioxetine and 19.9% for venlafaxine (p = .028); the corresponding STP Mood and Functioning rates were 28.0% and 23.5% (p = .281). Drug costs for the 8-week treatment period were CN¥1954 for vortioxetine and CN¥700 for venlafaxine. The incremental cost per STP for vortioxetine versus venlafaxine was CN¥13,938 for Mood and Tolerability and CN¥27,876 for Mood and Functioning.

Conclusions: Higher rates of dual treatment success were seen with vortioxetine versus venlafaxine. Although vortioxetine was not dominant in the base case, the incremental cost per STP for vortioxetine versus venlafaxine were overall within acceptable ranges. These results support the benefits previously reported with vortioxetine versus other antidepressants in broad efficacy, tolerability profile and cost-effectiveness.

Keywords:

• MDD
• antidepressants
• tolerability
• functional remission
• health economics

Notes

Transparency

Declaration of funding

The SOLUTION study was supported by H. Lundbeck A/S.

Declaration of financial/other relationships

GW has disclosed that she has received honoraria for being an advisor to or providing educational talks for Lundbeck, Pfizer, Sumitomo, Janssen and Janssen, and Eli Lilly Company. K.Z. has disclosed that he has received honoraria from Lundbeck, Pfizer, Johnson & Johnson, AstraZeneca, and Gilead. C.R.M., H.L., H.R., H.L.F.E. and A.E. have disclosed that they are full-time employees of H. Lundbeck A/S. CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

G.W., K.Z., C.R.M., H.L., H.R. and A.E. were involved in the conception and design of this work. H.L. and H.L.F.E. performed the data analyses, and C.R.M., H.L., H.R., H.L.F.E. and A.E. were involved in the interpretation of the data. H.L.F.E. developed the first draft of the manuscript; all authors revised the manuscript critically for intellectual content and all authors have approved of the final version to be published. All authors agree to be accountable for all aspects of the work.

Acknowledgements

The authors gratefully wish to thank all participants of the study, as well as the investigators and sites involved in conducting the SOLUTION study. No assistance in the preparation of this article is to be declared.

Data availability

The authors confirm that the data supporting the findings of this study are available within the article. The authors may be contacted for further data sharing.

Notes

i Brintellix, H. Lundbeck A/S, Valby, Denmark.

ii Effexor, Pfizer Inc., NY, USA.