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The cost-utility of maintenance treatment with venlafaxine in patients with recurrent major depressive disorder.

Sobocki P, Ekman M, Ovanfors A, Khandker R, Jönsson B - Int. J. Clin. Pract. (2008)

Bottom Line: In the base-case analysis, the cost per QALY gained of venlafaxine compared with no treatment was estimated at $18,500 over 2 years.In a probabilistic sensitivity analysis, we found that maintenance treatment with venlafaxine is cost-effective with 90% probability at a willingness to pay per QALY of $67,000 or less.Our long-term analyses also indicate that even under conservative assumptions about future risks of recurrences, maintenance treatment is cost-effective.

View Article: PubMed Central - PubMed

Affiliation: Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden.

ABSTRACT

Aims: The Prevention of Recurrent Episodes of Depression with venlafaxine XR for Two Years trial has reported advantages with maintenance treatment for patients with recurrent depressive disorder. The aim of this study was to assess the cost-utility of maintenance treatment with venlafaxine in patients with recurrent major depressive disorder, based on a recent clinical trial.

Methods: A Markov simulation model was constructed to assess the cost-utility of maintenance treatment for 2 years in recurrently depressed patients in Sweden. Risk of relapse and recurrence was based on a recent randomised clinical trial assessing the efficacy and tolerability of maintenance treatment with venlafaxine over 2 years. Costs and quality of life estimations were retrieved from a naturalistic longitudinal observational study conducted in Sweden. Health effects were quantified as quality-adjusted life-years (QALYs). Sensitivity analyses were conducted on key parameters employed in the model.

Results: In the base-case analysis, the cost per QALY gained of venlafaxine compared with no treatment was estimated at $18,500 over 2 years. In a probabilistic sensitivity analysis, we found that maintenance treatment with venlafaxine is cost-effective with 90% probability at a willingness to pay per QALY of $67,000 or less. Our long-term analyses also indicate that even under conservative assumptions about future risks of recurrences, maintenance treatment is cost-effective.

Conclusion: The present study indicates that maintenance treatment for 2 years with venlafaxine is cost-effective in patients with recurrent major depressive disorder.

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Related in: MedlinePlus

Cost-effectiveness acceptability curve. QALY, quality-adjusted life-year
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fig02: Cost-effectiveness acceptability curve. QALY, quality-adjusted life-year

Mentions: In the probabilistic sensitivity analysis we assessed the uncertainty around our base-case results. The combined uncertainty in the analysis is reported as a probabilistic cost-effectiveness acceptability curve (Figure 2). At a willingness to pay for an additional QALY of $40,000, venlafaxine is cost-effective in the maintenance treatment for recurrent depression at a probability of 80%, while at a willingness to pay for an additional QALY of $67,000, it is cost-effective at a probability of 90%.


The cost-utility of maintenance treatment with venlafaxine in patients with recurrent major depressive disorder.

Sobocki P, Ekman M, Ovanfors A, Khandker R, Jönsson B - Int. J. Clin. Pract. (2008)

Cost-effectiveness acceptability curve. QALY, quality-adjusted life-year
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2327222&req=5

fig02: Cost-effectiveness acceptability curve. QALY, quality-adjusted life-year
Mentions: In the probabilistic sensitivity analysis we assessed the uncertainty around our base-case results. The combined uncertainty in the analysis is reported as a probabilistic cost-effectiveness acceptability curve (Figure 2). At a willingness to pay for an additional QALY of $40,000, venlafaxine is cost-effective in the maintenance treatment for recurrent depression at a probability of 80%, while at a willingness to pay for an additional QALY of $67,000, it is cost-effective at a probability of 90%.

Bottom Line: In the base-case analysis, the cost per QALY gained of venlafaxine compared with no treatment was estimated at $18,500 over 2 years.In a probabilistic sensitivity analysis, we found that maintenance treatment with venlafaxine is cost-effective with 90% probability at a willingness to pay per QALY of $67,000 or less.Our long-term analyses also indicate that even under conservative assumptions about future risks of recurrences, maintenance treatment is cost-effective.

View Article: PubMed Central - PubMed

Affiliation: Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden.

ABSTRACT

Aims: The Prevention of Recurrent Episodes of Depression with venlafaxine XR for Two Years trial has reported advantages with maintenance treatment for patients with recurrent depressive disorder. The aim of this study was to assess the cost-utility of maintenance treatment with venlafaxine in patients with recurrent major depressive disorder, based on a recent clinical trial.

Methods: A Markov simulation model was constructed to assess the cost-utility of maintenance treatment for 2 years in recurrently depressed patients in Sweden. Risk of relapse and recurrence was based on a recent randomised clinical trial assessing the efficacy and tolerability of maintenance treatment with venlafaxine over 2 years. Costs and quality of life estimations were retrieved from a naturalistic longitudinal observational study conducted in Sweden. Health effects were quantified as quality-adjusted life-years (QALYs). Sensitivity analyses were conducted on key parameters employed in the model.

Results: In the base-case analysis, the cost per QALY gained of venlafaxine compared with no treatment was estimated at $18,500 over 2 years. In a probabilistic sensitivity analysis, we found that maintenance treatment with venlafaxine is cost-effective with 90% probability at a willingness to pay per QALY of $67,000 or less. Our long-term analyses also indicate that even under conservative assumptions about future risks of recurrences, maintenance treatment is cost-effective.

Conclusion: The present study indicates that maintenance treatment for 2 years with venlafaxine is cost-effective in patients with recurrent major depressive disorder.

Show MeSH
Related in: MedlinePlus