Cost-utility of selective serotonin reuptake inhibitors for depression in primary care in Catalonia.
OBJECTIVE
To determine the cost-utility of selective serotonin reuptake inhibitors (SSRIs) for treating depressive disorders prescribed in primary care (PC).


METHODS
A total of 301 participants beginning antidepressant treatment with an SSRI were enrolled in a prospective 6-month follow-up naturalistic study. Incremental cost-utility ratios (ICUR) were obtained for several comparisons among different SSRIs. To address uncertainty in the ICUR's sampling distribution, non-parametric bootstrapping was carried out.


RESULTS
Taking into account adjusted total costs and incremental quality of life gained, fluoxetine dominated paroxetine and citalopram with 63.4% and 79.3% of the bootstrap replications in the dominance quadrant, respectively. Additionally, fluoxetine was cost-effective over sertraline with 83.4% of the bootstrap replications below the threshold of 33,936 US$/quality-adjusted life year (30,000 euro/QALY).


CONCLUSIONS
Fluoxetine seems to be a better cost-utility SSRI option for treating depressive disorders in PC.
Serrano-Blanco
A
A
Sant Joan de Déu-Serveis de Salut Mental, Fundació Sant Joan de Déu, Sant Boi de Ll., Barcelona, Spain. aserrano@sjd.ssm.com
Pinto-Meza
A
A
Suárez
D
D
Peñarrubia
M T
MT
Haro
J M
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D002391:Catchment Area, Health; D015283:Citalopram / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005473:Fluoxetine / Q000191:economics / Q000627:therapeutic use; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017374:Paroxetine / Q000191:economics / Q000627:therapeutic use; D011320:Primary Health Care / Q000191:economics* / Q000706:statistics & numerical data; D017367:Selective Serotonin Reuptake Inhibitors / Q000191:economics* / Q000627:therapeutic use*; D020280:Sertraline / Q000191:economics / Q000627:therapeutic use; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology
D015283:Citalopram; D005473:Fluoxetine; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline