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Cost–utility of selective serotonin reuptake inhibitors for depression in primary care in Catalonia

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Abstract:

Serrano-Blanco A, Pinto-Meza A, Suárez D, Peñarrubia MT, Haro JM and the ETAPS Group (Efectivitat del Tractament antidepressiu en Atenció Primària de Salut). Cost–utility of selective serotonin reuptake inhibitors for depression in primary care in Catalonia. Objective: 

To determine the cost–utility of selective serotonin reuptake inhibitors (SSRIs) for treating depressive disorders prescribed in primary care (PC). Method: 

A total of 301 participants beginning antidepressant treatment with an SSRI were enrolled in a prospective 6-month follow-up naturalistic study. Incremental cost–utility ratios (ICUR) were obtained for several comparisons among different SSRIs. To address uncertainty in the ICUR's sampling distribution, non-parametric bootstrapping was carried out. Results: 

Taking into account adjusted total costs and incremental quality of life gained, fluoxetine dominated paroxetine and citalopram with 63.4% and 79.3% of the bootstrap replications in the dominance quadrant, respectively. Additionally, fluoxetine was cost-effective over sertraline with 83.4% of the bootstrap replications below the threshold of 33,936 US$/quality-adjusted life year (30,000 €/QALY). Conclusion: 

Fluoxetine seems to be a better cost–utility SSRI option for treating depressive disorders in PC.

Keywords: antidepressive agents; depressive disorder; economics; primary health care

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1600-0447.2006.00918.x

Affiliations: 1: Sant Joan de Déu-Serveis de Salut Mental, Fundació Sant Joan de Déu, Sant Boi de Ll., Barcelona 2: Primary Care Health Center Gavà II, Costa de Ponent Teaching Unit, Catalan Health Service, Barcelona, Spain

Publication date: December 1, 2006

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