Cost-utility analysis of vortioxetine versus agomelatine, bupropion SR, sertraline and venlafaxine XR after treatment switch in major depressive disorder in Finland.
BACKGROUND
To assess the cost-utility of vortioxetine versus relevant comparators (agomelatine, bupropion SR, sertraline, and venlafaxine XR) in the finnish setting in major depressive disorder (MDD) patients with inadequate response to selective serotonin- /serotonin-norepinephrine reuptake inhibitors.


METHODS
A one-year analysis was conducted using a decision tree with a Markov state transition component. The health states were remission, relapse and recovery. A Finnish healthcare payer perspective was adopted.


RESULTS
Vortioxetine was less costly and more effective versus all comparators in both direct and societal perspectives. Vortioxetine reduced the average annual direct costs by 4% versus venlafaxine XR and 8% versus sertraline. The greater efficacy associated with vortioxetine was translated into a higher percentage of patients in remission and recovery. The model was most sensitive to changes in remission rates at 8 weeks.


CONCLUSIONS
This cost-utility analysis showed vortioxetine to be a good alternative for MDD patients switching therapy in Finland.
a ESiOR Oy , Kuopio , Finland.
Erkki
E
Soini
a ESiOR Oy , Kuopio , Finland.
Taru
T
Hallinen
b Health Economics and Outcomes Research Department , Lundbeck , Issy-les-Moulineaux , France.
Mélanie
M
Brignone
c Mapi Group , Uxbridge , London , UK.
Rosanne
R
Campbell
d Global Analytics Department , Lundbeck , Issy-les-Moulineaux , France.
Françoise
F
Diamand
c Mapi Group , Uxbridge , London , UK.
Sandrine
S
Cure
e Lundbeck , Turku , Finland.
Maria
M
Aalto-Setälä
b Health Economics and Outcomes Research Department , Lundbeck , Issy-les-Moulineaux , France.
Natalya
N
Danchenko
f University of Helsinki and Helsinki University Hospital , Helsinki , Finland.
Hannu
H
Koponen
e Lundbeck , Turku , Finland.
Katarzyna
K
Kolasa
D000081:Acetamides / Q000008:administration & dosage / Q000191:economics; D000928:Antidepressive Agents / Q000008:administration & dosage* / Q000191:economics; D016642:Bupropion / Q000008:administration & dosage / Q000191:economics; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000191:economics; D005387:Finland; D006801:Humans; D008390:Markov Chains; D008962:Models, Theoretical; D010879:Piperazines / Q000008:administration & dosage* / Q000191:economics; D012008:Recurrence; D020280:Sertraline / Q000008:administration & dosage / Q000191:economics; D013440:Sulfides / Q000008:administration & dosage* / Q000191:economics; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride / Q000008:administration & dosage / Q000191:economics; D000078784:Vortioxetine; D009281:Naphthalenes
D000081:Acetamides; D000928:Antidepressive Agents; D016642:Bupropion; D010879:Piperazines; D020280:Sertraline; D013440:Sulfides; D000069470:Venlafaxine Hydrochloride; D000078784:Vortioxetine; C084711:agomelatine; D009281:Naphthalenes
Cost-utility analysis; agomelatine; bupropion SR; cost-effectiveness analysis; major depressive disorder; sertraline and venlafaxine XR; vortioxetine