title: Economic analysis of sildenafil citrate (Viagra) add-on to treat erectile dysfunction associated with selective serotonin reuptake inhibitor use.
abstract: The objective of this study was to compare the economic cost of adding sildenafil citrate (Viagra, Pfizer Inc., New York, NY) to treat selective serotonin reuptake inhibitor (SSRI)-induced erectile dysfunction with that of discontinuing antidepressant pharmacotherapy, switching patients to another SSRI, or adding a non-SSRI. Based on our real-world experience in an academic medical center, we performed an economic analysis of a hypothetical cohort of 1000 patients taking SSRIs on a course of acute and continuation treatment recommended by the American Psychiatric Association. We used standard costing of antidepressants, sildenafil, and unit costs for physician visits within a managed care environment and cost-of-illness methodology to calculate the annualized cost of depression for different treatment outcomes. After 6 months of SSRI treatment, the sildenafil add-on group had the lowest cost estimates compared with groups that discontinued SSRIs, substituted another SSRI (switching), or added a non-SSRI to the existing SSRI (augmentation). Sensitivity analyses demonstrated that the physician visit was the single most important cost component in this hypothetical population and relapse/remission the most costly outcome. Sildenafil can be a cost-effective add-on therapy to control SSRI-induced erectile dysfunction. Healthcare payors should consider this when developing optimum treatment strategies for men with depression.
authors.affiliation: Department of Psychiatry, University of New Mexico School of Medicine, 2400 Tucker NE, Albuquerque, NM 87131-5326, USA. geon@unm.edu
authors.forename: H George
authors.initials: HG
authors.lastname: Nurnberg
authors.forename: Sandeep
authors.initials: S
authors.lastname: Duttagupta
mesh_terms: D000928:Antidepressive Agents / Q000191:economics / Q000627:therapeutic use; D003365:Costs and Cost Analysis; D016527:Drug Costs; D007172:Erectile Dysfunction / Q000139:chemically induced / Q000188:drug therapy*; D006801:Humans; D008297:Male; D010726:Phosphodiesterase Inhibitors / Q000191:economics / Q000627:therapeutic use; D010879:Piperazines / Q000191:economics / Q000627:therapeutic use; D011687:Purines; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D000068677:Sildenafil Citrate; D013450:Sulfones
chemical_list: D000928:Antidepressive Agents; D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D017367:Selective Serotonin Reuptake Inhibitors; D000068677:Sildenafil Citrate; D013450:Sulfones