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  1. Choosing an antidepressant : effectiveness based pharmacoeconomics.

    Article - En anglais

    Background 

    SSRls have been one of the major innovations in psychopharmacology in recent years.

    The debate over the competing claims of SSRIs and the older, cheaper TCAs has implications for clinical practice and prescribing expenditure.

    Several reviewers have focused on acquisition costs and stressed the higher costs associated with using SSRIs.

    Methods 

    Recently there have been several applications of economics to the issue of whether to use SSRIs or TCAs as first-line antidepressants.

    Most have argued that there is an economic case for using SSRls.

    Several previous papers have used modelling techniques and decision analysis to generate economic evaluations from clinical trials.

    This paper examines some recent studies based on retrospective evaluations of real patients and real practices.

    Their methods and results are summarised and discussed.

    Results 

    They all suggest that in practice, where concerns are with effectiveness rather than efficacy, there are advantages to be gained from using SSRls.

    Conclusions 

    There are important questions about how to perform such economic evaluations.

    Clinical practice has long viewed the RCT as a'gold standard'for evaluation.

    Some SSRI/TCA comparisons, incorporating economic studies, are under way and will be reported on eventually.

    When they appear, these studies should be examined carefully for their implications for antidepressant prescribing.

    Mots-clés Pascal : Etat dépressif, Traitement, Chimiothérapie, Sertraline, Antidépresseur, Psychotrope, Coût financement, Service santé, Santé mentale, Indication, Homme, Trouble humeur

    Mots-clés Pascal anglais : Depression, Treatment, Chemotherapy, Sertraline, Antidepressant agent, Psychotropic, Financing cost, Health service, Mental health, Indication, Human, Mood disorder

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0224844

    Code Inist : 002B18H05B. Création : 11/09/1998.