title: Cost-effectiveness and cost-utility of selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, and tricyclic antidepressants in depression with comorbid cardiovascular disease.
abstract: OBJECTIVE
  There is a lack of clarity in the literature regarding the cost-effectiveness and cost-utility of antidepressants for treating real-world patients. The impact of comorbid cardiovascular disease (CVD) on the economic evaluations of antidepressants remains to be determined.
  
  
  METHODS
  Adult patients prescribed with antidepressants for depression were identified from the National Health Insurance Research Database in Taiwan. A cost-effectiveness and cost-utility analysis was conducted comparing selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs), and by the presence of comorbid CVD.
  
  
  RESULTS
  In terms of treatment success rates, SSRIs were the most cost-effective option compared to TCAs and SNRIs as revealed in the incremental cost-effectiveness ratios. The cost-effectiveness acceptability curves further showed differential findings in the cost-utility results by the presence of comorbid CVD.
  
  
  CONCLUSIONS
  To improve treatment success rates and quality-adjusted life years, SSRIs can be considered the most cost-effective option. Future research is needed to further clarify the impacts of physical comorbidities and other associated factors on the cost-effectiveness and cost-utility of pharmacological treatments in patients with depression.
authors.affiliation: Department of Psychiatry, Far Eastern Memorial Hospital, Taiwan; Centre for the Economics of Mental and Physical Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London, United Kingdom; School of Medicine, National Yang-Ming University, Taiwan. Electronic address: panyiju0211@gmail.com.
authors.forename: Yi-Ju
authors.initials: YJ
authors.lastname: Pan
authors.affiliation: School of Medicine, National Yang-Ming University, Taiwan; Division of Medical Imaging, Far Eastern Memorial Hospital, Taiwan.
authors.forename: Kuei-Hong
authors.initials: KH
authors.lastname: Kuo
authors.affiliation: Department of General Psychiatry, Taoyuan Psychiatric Center, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taiwan; School of Medicine, National Taiwan University, Taiwan.
authors.forename: Hung-Yu
authors.initials: HY
authors.lastname: Chan
authors.affiliation: Centre for the Economics of Mental and Physical Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: McCrone
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000928:Antidepressive Agents / Q000191:economics* / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003362:Cost-Benefit Analysis; D066264:Datasets as Topic / Q000706:statistics & numerical data; D003863:Depression / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data; D019057:Quality-Adjusted Life Years; D012680:Sensitivity and Specificity; D017367:Selective Serotonin Reuptake Inhibitors; D013624:Taiwan; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Antidepressant; Cardiovascular disease; Cost-effectiveness; Cost-utility; Depression