title: [Economic evaluation of desvenlafaxine in the treatment of major depressive disorder in Spain].
abstract: BACKGROUND
  The objective of this analysis was to evaluate the clinical and economic value of the use of 50mg-desvenlafaxine compared to the usual care (mix of duloxetine and venlafaxine) in the outpatient treatment of major depressive disorder after first line treatment failure (relapse) in Spain.
  
  
  METHODS
  A Markov model was used to follow up a cohort of major depressive disorder patients for one year after failure of first-line treatment with a serotonin-specific reuptake inhibitor and estimate outcome measures (percentage remission and depression-free days) and accrued and direct costs incurred during outpatient treatment of major depressive disorder. In order to obtain the efficacy data related to the treatment alternatives, a literature review of clinical trials was performed. A panel of clinical experts validated the use of clinical resources employed in the estimation of economic outcomes together with model assumptions. The analysis was performed in 2014 from the perspective of the National Health System.
  
  
  RESULTS
  Due to fewer discontinuations, initiating second line treatment with desvenlafaxine was associated with more depression-free days and a higher percentage of patients in remission versus usual care: 1.7 days and 0.5%, respectively. This was translated into lower drug and events management costs, and an overall cost reduction of €108 for the National Health System.
  
  
  CONCLUSIONS
  In patients who have not responded to a first-line serotonin-specific reuptake inhibitor therapy, desvenlafaxine-50mg was clinically similar in effectiveness, but a less costly option, compared with a weighted average of duloxetine and venlafaxine for the second-line treatment of major depressive disorder patients from a payer (National Health System) perspective in Spain.
authors.affiliation: Departamento de Farmacoeconomía e Investigación de Resultados en Salud, Pfizer, S. L. U., Alcobendas, Madrid, España. Electronic address: Javier.rejas@pfizer.com.
authors.forename: Javier
authors.initials: J
authors.lastname: Rejas Gutiérrez
authors.affiliation: Unidad de Psiquiatría, Servicio de Medicina, Badalona Serveis Assistencials S. A., Badalona, Barcelona, España.
authors.forename: Milagrosa
authors.initials: M
authors.lastname: Blanca Tamayo
authors.affiliation: Servicio de Psiquiatría, Hospital Universitario Mútua Terrassa, Terrassa, Barcelona, España.
authors.forename: Josep
authors.initials: J
authors.lastname: Gascón Barrachina
authors.affiliation: Departamento Médico, Pfizer, S. L. U., Alcobendas, Madrid, España.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Armada Peláez
mesh_terms: D003362:Cost-Benefit Analysis; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000191:economics; D000069468:Desvenlafaxine Succinate / Q000191:economics* / Q000627:therapeutic use; D016527:Drug Costs; D004359:Drug Therapy, Combination; D000068736:Duloxetine Hydrochloride / Q000191:economics / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008390:Markov Chains; D018803:Models, Economic; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors / Q000191:economics* / Q000627:therapeutic use; D013030:Spain; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride / Q000191:economics / Q000627:therapeutic use
chemical_list: D000068760:Serotonin and Noradrenaline Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride; D000068736:Duloxetine Hydrochloride; D000069468:Desvenlafaxine Succinate
keywords: Antidepresivos; Antidepressive agents; Cost-effectiveness; Coste-efectividad; Depresión; Economic evaluation; Evaluación económica; Inhibidor selectivo de la recaptación de serotonina; Major depressive disorder; Serotonin uptake inhibitors