Cost-effectiveness of mirtazapine relative to fluoxetine in the treatment of moderate and severe depression in France
In: The European journal of psychiatry, Jg. 14 (2000), Heft 1, S. 15-25
academicJournal
- print; 17 ref
Zugriff:
The objective of this study was to estimate the cost-effectiveness of mirtazapine, compared to fluoxetine, in the management of moderate and severe depression among outpatients in France, from the perspective of the Social Security Fund. The economic analysis was based on clinical differences obtained from a six week comparative trial with mirtazapine and fluoxetine, which were extrapolated to six months using assumptions derived from the literature. Using treatment paths developed from the clinical trial data, the published literature and interviews with a French Delphi Panel, clinical decision analysis techniques enabled the expected direct Social Security costs and the expected indirect costs due to lost productivity to be estimated over six months at 1995/96 prices. This study was critically appraised by an Expert Panel who endorsed and supported the analysis and its assumptions. Using mirtazapine instead of fluoxetine for six months increased the proportion of successfully treated patients by 22% (from 15.6% to 19.1%), albeit for a negligible additional Social Security cost of FF117 per patient (from FF22,682 to FF22,799). Consequently, the expected direct cost per patient successfully treated with mirtazapine was FF98,883 compared to FF99,310 for a fluoxetine-treated patient. The expected indirect cost to French society was FF98,883 per mirtazapine-treated patient, compared to FF99,310 per fluoxetine-treated patient. Social Security payments to patients during their time off work emerged as the main cost driver, accounting for up to 86% of the expected direct cost per patient. In contrast, the acquisition costs of antidepressants accounted for between 1% and 3% of the expected direct cost per patient. The analysis used an acquisition cost (public price) of FF8.98 per 30mg of mirtazapine, but across a range of acquisition costs, up to FF15 per 30mg, mirtazapine remained cost-effective relative to fluoxetine. In conclusion, this study demonstrated that despite the differences in acquisition costs, mirtazapine is potentially a cost-effective antidepressant compared to fluoxetine in the management of moderate and severe depression in France.
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Cost-effectiveness of mirtazapine relative to fluoxetine in the treatment of moderate and severe depression in France
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Autor/in / Beteiligte Person: | BROWN, M. C. J ; VAN LOO, J. M. T ; GUEST, J. F |
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Zeitschrift: | The European journal of psychiatry, Jg. 14 (2000), Heft 1, S. 15-25 |
Veröffentlichung: | Saragosse: INO, 2000 |
Medientyp: | academicJournal |
Umfang: | print; 17 ref |
ISSN: | 0213-6163 (print) |
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