title: Impact of the STAR*D trial from the perspective of the payer.
abstract: The authors discuss implications for private and public insurers of the STAR*D trial (Sequenced Treatment Alternatives to Relieve Depression), which found evidence that for second- and third-line treatment, no second-generation antidepressant was superior to another in terms of effectiveness or of the overall incidence of harmful effects. These findings have permitted payers to construct formulary coverage rules with more confidence and have highlighted the benefits of policies that improve access to care (for example, encouraging primary care treatment of depression) or promote treatment adherence (for example, implementing pay-for-performance initiatives).
authors.affiliation: Center for Evidence-Based Policy, Oregon Health and Science University, Portland, OR 97201, USA. littleal@ohsu.edu
authors.forename: Alison
authors.initials: A
authors.lastname: Little
authors.forename: Richard A
authors.initials: RA
authors.lastname: Hansen
authors.forename: Gerald
authors.initials: G
authors.lastname: Gartlehner
authors.forename: Carrie
authors.initials: C
authors.lastname: Gray
mesh_terms: D003865:Major Depressive Disorder / Q000188:drug therapy / Q000191:economics* / Q000628:therapy; D006291:Health Policy; D006801:Humans; D019458:Insurance Coverage / Q000191:economics; D007348:Insurance, Health / Q000191:economics*; D010349:Patient Compliance; D017367:Selective Serotonin Reuptake Inhibitors / Q000191:economics / Q000627:therapeutic use; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors