title: Cost-effectiveness of pregabalin versus venlafaxine in the treatment of generalized anxiety disorder: findings from a Spanish perspective.
abstract: The objective of the present study was to describe a new model of the cost-effectiveness of treatment of generalized anxiety disorder (GAD) and its application to a comparison of pregabalin versus venlafaxine extended-release (XR) from a Spanish healthcare perspective. Microsimulation techniques, including Hamilton Anxiety Scale (HAM-A) score, number of weeks with minimal or no anxiety (HAM-A <or= 9), and quality-adjusted life-years (QALYs), were used to predict treatment outcomes for patients with moderate-to-severe GAD who would be treated with pregabalin vs venlafaxine XR. Expected levels of healthcare utilization and unit cost of care are derived from Spanish published sources. We express cost-effectiveness alternatively in terms of incremental cost per additional week with minimal or no anxiety, and incremental cost per QALY gained [in 2007 Euros (euro)]. Considering costs of drug treatment only, the incremental cost [mean (95% confidence interval)] of pregabalin (vs venlafaxine XR) would be euro96 (euro86, euro107) per additional week with minimal or no anxiety, and euro32,832 (euro29,656, euro36,308) per QALY gained. When other medical care costs are considered, cost-effectiveness ratios decline to euro70 (euro61, euro80) per additional week with no or minimal anxiety, and euro23,909 (euro20,820, euro27,006) per QALY gained. We conclude that, using a new microsimulation model of the treatment of GAD, pregabalin appears to be cost-effective vs venlafaxine XR in a Spanish healthcare setting.
authors.affiliation: Policy Analysis Inc. (PAI), Brookline, MA, 02445, USA. veramo@pai2.com
authors.forename: Montserrat
authors.initials: M
authors.lastname: Vera-Llonch
authors.forename: Ellen
authors.initials: E
authors.lastname: Dukes
authors.forename: Javier
authors.initials: J
authors.lastname: Rejas
authors.forename: Oleg
authors.initials: O
authors.lastname: Sofrygin
authors.forename: Marko
authors.initials: M
authors.lastname: Mychaskiw
authors.forename: Gerry
authors.initials: G
authors.lastname: Oster
mesh_terms: D000927:Anticonvulsants / Q000191:economics* / Q000627:therapeutic use; D018687:Antidepressive Agents, Second-Generation / Q000191:economics* / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000188:drug therapy / Q000191:economics*; D016001:Confidence Intervals; D003362:Cost-Benefit Analysis; D003511:Cyclohexanols / Q000191:economics* / Q000627:therapeutic use; D003692:Delayed-Action Preparations; D017850:Economics, Pharmaceutical; D006801:Humans; D018803:Models, Economic; D015233:Models, Statistical; D009010:Monte Carlo Method; D000069583:Pregabalin; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D019057:Quality-Adjusted Life Years; D013030:Spain; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D018687:Antidepressive Agents, Second-Generation; D003511:Cyclohexanols; D003692:Delayed-Action Preparations; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D000069470:Venlafaxine Hydrochloride