title: Managing antidepressant drug therapy in an evolving marketplace.
abstract: The availability of generic SSRI antidepressants has simplified formulary decisions related to how best to treat uncomplicated depression. However, several new challenges have arisen. Better data are needed to guide formulary guidelines concerning the reuse of nonpreferred antidepressants for patients with recurrent episodes of depression and the risks associated with switching long-term patients to generic SSRIs. Managed care organizations need more information on the appropriateness of expanding the use of generic SSRIs to treat less severe forms of depression. An expansion of the use of antidepressant therapy will likely reduce HEDIS compliance performance, which could adversely affect the marketing of the plan to potential enrollees. Plans must also consider FDA concerns that the newer antidepressants may increase suicidality in a small number of patients. Finally, more research is needed to determine if the generic SSRIs adequately meet the therapeutic needs of more severely ill patients, such as treatment refractory depressed patients and patients with bipolar disorders.
authors.affiliation: Department of Pharmaceutical Economics and Policy, USC School of Pharmacy, Los Angeles, California, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: McCombs
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use*; D003695:Delivery of Health Care / Q000458:organization & administration; D003863:Depression / Q000188:drug therapy; D006801:Humans; D007255:Information Services; D008329:Managed Care Programs / Q000458:organization & administration; D011787:Quality of Health Care; D014481:United States
chemical_list: D000928:Antidepressive Agents