Cost effectiveness of fluvoxamine in the treatment of recurrent depression in France.
OBJECTIVE
The objective of this study was to examine the cost effectiveness of fluvoxamine compared with tricyclic antidepressants (TCAs) in the treatment of patients with depressive episodes.


METHODS
A Markov process model was constructed to model the effectiveness, as measured by time without depression, and the costs of both treatments. The model examined a period of 18 months in order to capture the influence of both relapses and recurrences on the outcomes. Data for the construction of the model came from the published literature, an expert panel and a large multicentre randomised clinical trial. Costs were obtained from published sources. The setting for this study was France.


RESULTS
The results of the baseline analysis showed that the use of fluvoxamine in the maintenance treatment (recurrence prevention) of depressive disorders was less costly than TCAs with total costs (direct and indirect costs) of 40,232.40 French francs (FF) and FF52,257.53, respectively (1996 values). In addition, due to the prevention of relapse and recurrence, effectiveness favoured fluvoxamine as it was associated with a longer period of time without depression when compared with TCAs (79% of the study period vs 71%). Sensitivity analyses confirmed the robustness of these findings.


CONCLUSIONS
In conclusion, on the basis of the assumptions used in the model, the use of fluvoxamine as maintenance therapy is clinically and economically justified in patients with depressive disorders.
Nuijten
M
M
Lewin Group, Hoofddorp, The Netherlands. mnuyten@qbnt.quintiles.com
Hadjadjeba
L
L
Evans
C
C
van den Berg
J
J
D018687:Antidepressive Agents, Second-Generation / Q000191:economics* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003866:Depressive Disorder / Q000188:drug therapy / Q000191:economics*; D016666:Fluvoxamine / Q000191:economics* / Q000627:therapeutic use; D005602:France; D006801:Humans; D008390:Markov Chains; D017367:Selective Serotonin Reuptake Inhibitors / Q000191:economics* / Q000627:therapeutic use; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D016666:Fluvoxamine; D017367:Selective Serotonin Reuptake Inhibitors