Effectiveness and cost-effectiveness of antidepressants in primary care: a multiple treatment comparison meta-analysis and cost-effectiveness model.

<h4>Objective</h4>To determine effectiveness and cost-effectiveness over a one-year time horizon of pharmacological first line treatment in primary care for patients with moderate to severe depression.<h4>Design</h4>A multiple treatment comparison meta-analysis was employed t...

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Autores principales:	Joakim Ramsberg, Christian Asseburg, Martin Henriksson
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/3df020ee120c4f35b7dc56a03707f54e
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spelling	oai:doaj.org-article:3df020ee120c4f35b7dc56a03707f54e2021-11-18T07:09:58ZEffectiveness and cost-effectiveness of antidepressants in primary care: a multiple treatment comparison meta-analysis and cost-effectiveness model.1932-620310.1371/journal.pone.0042003https://doaj.org/article/3df020ee120c4f35b7dc56a03707f54e2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22876296/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>To determine effectiveness and cost-effectiveness over a one-year time horizon of pharmacological first line treatment in primary care for patients with moderate to severe depression.<h4>Design</h4>A multiple treatment comparison meta-analysis was employed to determine the relative efficacy in terms of remission of 10 antidepressants (citalopram, duloxetine escitalopram, fluoxetine, fluvoxamine mirtazapine, paroxetine, reboxetine, sertraline and venlafaxine). The estimated remission rates were then applied in a decision-analytic model in order to estimate costs and quality of life with different treatments at one year.<h4>Data sources</h4>Meta-analyses of remission rates from randomised controlled trials, and cost and quality-of-life data from published sources.<h4>Results</h4>The most favourable pharmacological treatment in terms of remission was escitalopram with an 8- to 12-week probability of remission of 0.47. Despite a high acquisition cost, this clinical effectiveness translated into escitalopram being both more effective and having a lower total cost than all other comparators from a societal perspective. From a healthcare perspective, the cost per QALY of escitalopram was €3732 compared with venlafaxine.<h4>Conclusion</h4>Of the investigated antidepressants, escitalopram has the highest probability of remission and is the most effective and cost-effective pharmacological treatment in a primary care setting, when evaluated over a one year time-horizon. Small differences in remission rates may be important when assessing costs and cost-effectiveness of antidepressants.Joakim RamsbergChristian AsseburgMartin HenrikssonPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 8, p e42003 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Joakim Ramsberg Christian Asseburg Martin Henriksson Effectiveness and cost-effectiveness of antidepressants in primary care: a multiple treatment comparison meta-analysis and cost-effectiveness model.
description	<h4>Objective</h4>To determine effectiveness and cost-effectiveness over a one-year time horizon of pharmacological first line treatment in primary care for patients with moderate to severe depression.<h4>Design</h4>A multiple treatment comparison meta-analysis was employed to determine the relative efficacy in terms of remission of 10 antidepressants (citalopram, duloxetine escitalopram, fluoxetine, fluvoxamine mirtazapine, paroxetine, reboxetine, sertraline and venlafaxine). The estimated remission rates were then applied in a decision-analytic model in order to estimate costs and quality of life with different treatments at one year.<h4>Data sources</h4>Meta-analyses of remission rates from randomised controlled trials, and cost and quality-of-life data from published sources.<h4>Results</h4>The most favourable pharmacological treatment in terms of remission was escitalopram with an 8- to 12-week probability of remission of 0.47. Despite a high acquisition cost, this clinical effectiveness translated into escitalopram being both more effective and having a lower total cost than all other comparators from a societal perspective. From a healthcare perspective, the cost per QALY of escitalopram was €3732 compared with venlafaxine.<h4>Conclusion</h4>Of the investigated antidepressants, escitalopram has the highest probability of remission and is the most effective and cost-effective pharmacological treatment in a primary care setting, when evaluated over a one year time-horizon. Small differences in remission rates may be important when assessing costs and cost-effectiveness of antidepressants.
format	article
author	Joakim Ramsberg Christian Asseburg Martin Henriksson
author_facet	Joakim Ramsberg Christian Asseburg Martin Henriksson
author_sort	Joakim Ramsberg
title	Effectiveness and cost-effectiveness of antidepressants in primary care: a multiple treatment comparison meta-analysis and cost-effectiveness model.
title_short	Effectiveness and cost-effectiveness of antidepressants in primary care: a multiple treatment comparison meta-analysis and cost-effectiveness model.
title_full	Effectiveness and cost-effectiveness of antidepressants in primary care: a multiple treatment comparison meta-analysis and cost-effectiveness model.
title_fullStr	Effectiveness and cost-effectiveness of antidepressants in primary care: a multiple treatment comparison meta-analysis and cost-effectiveness model.
title_full_unstemmed	Effectiveness and cost-effectiveness of antidepressants in primary care: a multiple treatment comparison meta-analysis and cost-effectiveness model.
title_sort	effectiveness and cost-effectiveness of antidepressants in primary care: a multiple treatment comparison meta-analysis and cost-effectiveness model.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/3df020ee120c4f35b7dc56a03707f54e
work_keys_str_mv	AT joakimramsberg effectivenessandcosteffectivenessofantidepressantsinprimarycareamultipletreatmentcomparisonmetaanalysisandcosteffectivenessmodel AT christianasseburg effectivenessandcosteffectivenessofantidepressantsinprimarycareamultipletreatmentcomparisonmetaanalysisandcosteffectivenessmodel AT martinhenriksson effectivenessandcosteffectivenessofantidepressantsinprimarycareamultipletreatmentcomparisonmetaanalysisandcosteffectivenessmodel
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Effectiveness and cost-effectiveness of antidepressants in primary care: a multiple treatment comparison meta-analysis and cost-effectiveness model.

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