Cost-effectiveness of newer antidepressants compared with tricyclic antidepressants in managed care settings.
Our aim was to determine the cost-effectiveness of newer antidepressants compared with tricyclic antidepressants in managed care organization settings.
We employed cost-utility analysis based on a clinical decision analysis model derived from published medical literature and physician judgment.
The model, which represents ideal primary care practice, compares treatment with nefazodone to treatment with either imipramine or fluoxetine or to a step approach involving initial treatment with imipramine followed by nefazodone for treatment failures.
The outcome measures were lifetime medical costs, quality-adjusted life years (QALYs), and costs per QALY gained.
The base case analysis found that nefazodone treatment had $16,669 in medical costs, compared with $15,348 for imipramine, $16,061 for the imipramine step approach, and $16,998 for fluoxetine.
QALYs were greatest for nefazodone (14.64), compared with 14.32 for imipramine, 14.40 for the step approach, and 14.58 for fluoxetine.
The cost-effectiveness ratio comparing nefazodone with imipramine was $4065 per QALY gained.
The cost-effectiveness ratio comparing nefazodone with the step approach was $2555 per QALY gained.
There were only minor differences in costs and outcomes between nefazodone and fluoxetine, with nefazodone resulting in $329 fewer costs and 0.06 more QALYs. (...)
Mots-clés Pascal : Etat dépressif, Trouble humeur, Chimiothérapie, Antidépresseur, Psychotrope, Etude comparative, Composé tricyclique, Inhibiteur recapture, Sérotonine, Analyse coût, Soin intégré, Qualité vie, Economie santé, Néfazodone, Imipramine, Fluoxétine, Homme
Mots-clés Pascal anglais : Depression, Mood disorder, Chemotherapy, Antidepressant agent, Psychotropic, Comparative study, Tricyclic compound, Reuptake inhibitor, Serotonin, Cost analysis, Managed care, Quality of life, Health economy, Nefazodone, Imipramine, Fluoxetine, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0250251
Code Inist : 002B02B02. Création : 11/06/1997.