title: Cost and effectiveness of venlafaxine extended-release and selective serotonin reuptake inhibitors in the acute phase of outpatient treatment for major depressive disorder.
abstract: OBJECTIVE
  The purpose of this retrospective analysis was to estimate the cost and effectiveness of venlafaxine extended-release (VXR) compared with selective serotonin reuptake inhibitors in the outpatient treatment of major depressive disorder.
  
  
  METHODS
  Pooled data from 8, 8-week, randomized, double-blind studies comparing treatment of major depressive disorder with venlafaxine/venlafaxine XR (n = 851), selective serotonin reuptake inhibitors (fluoxetine, paroxetine, fluvoxamine; n = 748), or placebo (4 studies; n = 446) were retrospectively analyzed to determine the economic implications of symptom remission from the perspective of a US third party payer and that of an employer. A decision modeling approach was used to determine cost and effectiveness ratios.
  
  
  RESULTS
  Patients on VXR were associated with 22.8 depression-free days versus 18.6 depression-free days with the studied selective serotonin reuptake inhibitors, based on the decision model. Productive and quality-adjusted days were also expected to increase for VXR patients (22.06 vs. 19.34 and 4.56 to 9.36 vs. 3.72 to 7.63), as was the percentage of patients achieving full activity (25.9% vs. 19.6%). The expected cost per patient achieving remission of symptoms was US 1303.94 dollars and US 1514.96 dollars, and the cost per depression-free days was US 25.66 dollars and US 28.25 dollars, for the VXR and selective serotonin reuptake inhibitors groups, respectively.
  
  
  CONCLUSIONS
  Treatment with VXR is not only expected to increase the rate of remission of symptoms but is also associated with achievement of full activity, higher number of depression-free days, productive days, and quality-adjusted days. VXR is a cost-effective treatment option for major depressive disorder.
authors.affiliation: Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390-9119, USA. Madhukar.trivedi@utsouthwestern.edu
authors.forename: Madhukar H
authors.initials: MH
authors.lastname: Trivedi
authors.forename: George J
authors.initials: GJ
authors.lastname: Wan
authors.forename: Rajiv
authors.initials: R
authors.lastname: Mallick
authors.forename: Jieling
authors.initials: J
authors.lastname: Chen
authors.forename: Roman
authors.initials: R
authors.lastname: Casciano
authors.forename: Erika C
authors.initials: EC
authors.lastname: Geissler
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Panish
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000208:Acute Disease; D000553:Ambulatory Care / Q000191:economics; D003362:Cost-Benefit Analysis; D003511:Cyclohexanols / Q000191:economics* / Q000627:therapeutic use*; D003661:Decision Support Techniques; D003692:Delayed-Action Preparations / Q000191:economics; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000191:economics*; D004311:Double-Blind Method; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D005473:Fluoxetine / Q000191:economics / Q000627:therapeutic use; D016666:Fluvoxamine / Q000191:economics / Q000627:therapeutic use; D006801:Humans; D008297:Male; D017374:Paroxetine / Q000191:economics / Q000627:therapeutic use; D019057:Quality-Adjusted Life Years; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000191:economics* / Q000627:therapeutic use; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride
chemical_list: D003511:Cyclohexanols; D003692:Delayed-Action Preparations; D005473:Fluoxetine; D016666:Fluvoxamine; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride