Title: A Prospective 8-Week Comparison of Cost-Effectiveness of two Antidepressants: Escitalopram and Milnacipran at Tertiary Heath Care Center
Author: Dr Meghna Shinde
DOI: https://dx.doi.org/10.18535/jmscr/v6i2.214
Abstract
Background: Depression is a prevalent psychiatric disorder that is responsible for considerable societal and economic burden. This prospective study aims to generate and compare the data on cost effectiveness of the antidepressants Escitalopram and Milnacipran.
Methods: All consenting adults (n =120) diagnosed with depression were treated with open label Escitalopram (10–20 mg) or Milnacipran (50-100mg) for a duration of 8 weeks. The cost effectiveness was calculated by the average rupee cost per responder in both the groups who completed 8 weeks of entire study period without discontinuing medication.
Results: In Escitalopram group, the average cost of medication in responders (83.3%) was 579.1 rupees whereas in Milnacipran group, the average cost in responders (75.6%)who completed 8 weeks of treatment was 593.5 rupees.
Conclusion: Escitalopram is more cost-effective than Milnacipran.
Keywords: Escitalopram, Milnacipran, responders, cost-effectiveness.
References
- Murali Madhav S. Epidemiological Study of Prevalence of Mental Disorders in India: Indian Journal of Community Medicine2001-10 - 2001-12 Vol. 26, No. 4.
- Murray CJ, Lopez AD. The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases. Injuries and Risk Factors in 1990 and Projected to 2020.Cambridge, MA: Harvard University Press; 1996.
- Greenberg PE, Kessler RC, Nell TL, et al: Depression in the work place: an economic perspective, in Selective Serotonin Reuptake Inhibitors: Advances in Basic Research and Clinical Practice. Edited by Feigher JP, Boyer WF. New York, Wiley, 1996, pp 327-363
- Jönsson B, Bebbington PE. What price depression? The cost of depression and the cost-effectiveness of pharmacological treatment. Br J Psychiatry. 1994; 164:665–73.
- Le Pen C, Levy E, Ravily V, Beuzen JN, Meurgey F. The cost of treatment dropout in depression. A cost-benefit analysis of fluoxetine vs. tricyclics. J Affect Disord. 1994;31:1–18
- Hatziandreu EJ, Brown RE, Revicki DA, Turner R, Martindale J, Levine S, et al. Cost utility of maintenance treatment of recurrent depression with sertraline versus episodic treatment with dothiepin. Pharmacoeconomics. 1994;5:249–68.
- Burke WJ, Gergel I, Bose A. Fixed-dose trial of the single isomer SSRI escitalopram in depressed outpatients. J Clin Psychiatry. 2002;63(4):331–336.
- Lepola UM, Loft H, Reines EH. Escitalopram 10–20 mg/day) is effective and well tolerated in a placebo-controlled study in depression in primary care. Int Clin Psychopharmacol. 2003;18(4):211–217.
- Lalit V, Appaya PM, Hegde RP, et al. Escitalopram versus citalopram and sertraline: a double-blind controlled, multi-centric trial in Indian patients with unipolar major depression. Indian J Psychiatry. 2004;46(4):333–341.
- Kennedy SH, Andersen HF, Thase ME. Escitalopram in the treatment of major depressive disorder: a meta-analysis. Curr Med Res Opin. 2009; 25(1):161–175.
- Khan A, Bose A, Alexopoulos GS, Gommoll C, Li D, Gandhi C. Double-blind comparison of escitalopram and duloxetine in the acute treatment of major depressive disorder. Clin Drug Investig. 2007; 27(7): 481–492.
- Bielski RJ, Ventura D, Chang CC. A double-blind comparison of escitalopram and venlafaxine extended release in the treatment of major depressive disorder. J Clin Psychiatry. 2004;65(9):1190–1196.
- Montgomery SA, Huusom AK, Bothmer J. A randomised study comparing escitalopram with venlafaxine XR in primary care patients with major depressive disorder. 2004;50 (1):57–64.
- Montgomery SA, Kasper S. Comparison of compliance between serotonin reuptake inhibitors and tricyclic antidepressants: A meta-analysis. Int Clin Psychopharmacol. 1995;9(Suppl 4):33–40.
- Barrett B, Byford S, Knapp M. Evidence of cost-effective treatments for depression: A systematic review. J Affect Disord. 2005; 84:1–13.