title: Cost-effectiveness of outpatient treatment in depressive patients with escitalopram in Germany.
abstract: We investigated the cost-effectiveness of escitalopram (10 mg daily dose) vs. venlafaxine XR (75 mg daily dose) in a German outpatient setting for the treatment of unipolar depression (MADRS score 20-34) over a period of 70 days. To assess the cost effectiveness of the two substances we combined data from physician's surveys and clinical response data; cost-effectiveness was calculated using a Markov model. In a second step we considered the therapeutic decisions of the attending physicians. Cost-effectiveness was indicated as costs per successfully treated patient. Escitalopram demonstrated a more favorable cost-effectiveness ratio than venlafaxine XR. The analysis of treatment patterns showed that attending physicians intervene fairly early if the chosen therapy is ineffective. Additional costs for the use of venlafaxine XR over those of escitalopram were estimated from Euro 7,446 to Euro 9.836 per successfully treated per patient. Hence escitalopram may be a cost-effective alternative to venlafaxine XR in outpatient care setting in Germany.
authors.affiliation: Institut für Versicherungsbetriebslehre, University of Hanover, Germany. wk@ivbl.uni-hannover.de
authors.forename: Werner
authors.initials: W
authors.lastname: Kulp
authors.forename: J-M Graf
authors.initials: JM
authors.lastname: von der Schulenburg
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Greiner
mesh_terms: D000553:Ambulatory Care / Q000191:economics; D018687:Antidepressive Agents, Second-Generation / Q000191:economics* / Q000627:therapeutic use*; D015283:Citalopram / Q000191:economics* / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D003511:Cyclohexanols / Q000191:economics* / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000191:economics; D016527:Drug Costs / Q000706:statistics & numerical data*; D004363:Drug Utilization; D005858:Germany; D019538:Health Care Surveys; D006801:Humans; D008390:Markov Chains; D017059:Models, Econometric; D016032:Randomized Controlled Trials as Topic; D017367:Selective Serotonin Reuptake Inhibitors / Q000191:economics* / Q000627:therapeutic use*; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram; D003511:Cyclohexanols; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride