Generic fluoxetine and choice of antidepressant medication.
OBJECTIVE
In 2002 generic fluoxetine, the first generic product in a relatively expensive medication class, became available at Veterans Affairs medical centers at only 5% of its previous cost. This study examined whether its availability was associated with an increase in use compared with other medications.


METHODS
All new starts of 15 antidepressants during fiscal year (FY) 2001 (before generic fluoxetine became available) and FY2003 were identified from administrative records, and the change in proportions of new starts across years was examined.


RESULTS
Altogether, 55,673 patients had a new start on antidepressants in FY2001 and 48,002 had a new start in FY2003. The percentage of fluoxetine prescriptions (both branded and generic) rose only 1.2%--from 8.3% in FY2001 to 9.5% in FY2003.


CONCLUSIONS
Only a small increase was found in the rate of new starts of fluoxetine in the year after its release as a low-cost generic. There appear to be untapped opportunities to realize savings for antidepressants with appropriate administrative mechanisms and incentives.
Sernyak
Michael J
MJ
Psychiatry Service, 116A, Veterans Affairs Connecticut Healthcare System, 950 Campbell Ave., West Haven, CT 06516, USA. michael.sernyak@yale.edu
Rosenheck
Robert A
RA
D002755:Choice Behavior; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000191:economics; D016568:Drugs, Generic / Q000191:economics; D005473:Fluoxetine / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D017367:Selective Serotonin Reuptake Inhibitors / Q000191:economics / Q000627:therapeutic use*; D014481:United States
D016568:Drugs, Generic; D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors