Cost-utility analysis of vortioxetine versus agomelatine, bupropion SR, sertraline and venlafaxine XR after treatment switch in major depressive disorder in Finland

ABSTRACT

Background: To assess the cost-utility of vortioxetine versus relevant comparators (agomelatine, bupropion SR, sertraline, and venlafaxine XR) in the finnish setting in major depressive disorder (MDD) patients with inadequate response to selective serotonin- /serotonin–norepinephrine reuptake inhibitors.

Methods: A one-year analysis was conducted using a decision tree with a Markov state transition component. The health states were remission, relapse and recovery. A Finnish healthcare payer perspective was adopted.

Results: Vortioxetine was less costly and more effective versus all comparators in both direct and societal perspectives. Vortioxetine reduced the average annual direct costs by 4% versus venlafaxine XR and 8% versus sertraline. The greater efficacy associated with vortioxetine was translated into a higher percentage of patients in remission and recovery. The model was most sensitive to changes in remission rates at 8 weeks.

Conclusion: This cost-utility analysis showed vortioxetine to be a good alternative for MDD patients switching therapy in Finland.

KEYWORDS:

• Cost-utility analysis
• cost-effectiveness analysis
• major depressive disorder
• vortioxetine
• agomelatine
• bupropion SR
• sertraline and venlafaxine XR

Declaration of interest

ES is the CEO and a founding partner of and, with TH is a founding partner and employee of ESiOR Oy, Kuopio, Finland. ESiOR was financially supported by Oy H. Lundbeck AB for the management, conceptualization and design, data acquisition, data analysis and interpretation, modelling, reporting, drafting and revision of the study. H. Lundbeck is the marketer of vortioxetine in Finland. MB, ND and FD are employees of Lundbeck SAS, Issy-les-Moulineaux, France. RC and SC were employees of MAPI SAS that received financial support from Lundbeck for their technical support, scientific contribution in the global model development and manuscript preparation. MAS is an employee of Oy H. Lundbeck Ab, Turku, Finland. HJK has received consultation fees from Takeda and lecturing fees from Oy H. Lundbeck Ab and Professio. KK was an employee of Oy H. Lundbeck Ab, Turku, Finland, at the time of study. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This study was financially supported by Oy H. Lundbeck Ab, Turku, Finland, and Lundbeck SAS, France.