Cost-effectiveness of depressive episode pharmacological treatment
Background and Objectives There is a paucity of published cost-effectiveness studies of alternative scenarios in depressive episode acute medical care in Eastern European populations. Methods Prospective cost-effectiveness analysis was conducted on 65 depressive patients in a large university clinic...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Srpsko lekarsko drustvo
2015-01-01
|
| Series: | Hospital Pharmacology |
| Subjects: | |
| Online Access: | http://scindeks-clanci.ceon.rs/data/pdf/2334-9492/2015/2334-94921501235J.pdf |
| _version_ | 1818525728420921344 |
|---|---|
| author | Jakovljević Mihajlo B. Tetsuji Yamada Ching Chia Chen Stevanović Dejan S. Jovanović Mirjana R. Nikić-Đuričić Katarina D. Rančić Nemanja K. Savić Dejana M. Biorac Nenad M. Mihajlović Goran S. Janković Slobodan M. |
| author_facet | Jakovljević Mihajlo B. Tetsuji Yamada Ching Chia Chen Stevanović Dejan S. Jovanović Mirjana R. Nikić-Đuričić Katarina D. Rančić Nemanja K. Savić Dejana M. Biorac Nenad M. Mihajlović Goran S. Janković Slobodan M. |
| author_sort | Jakovljević Mihajlo B. |
| collection | DOAJ |
| description | Background and Objectives There is a paucity of published cost-effectiveness studies of alternative scenarios in depressive episode acute medical care in Eastern European populations. Methods Prospective cost-effectiveness analysis was conducted on 65 depressive patients in a large university clinic [May 2010-February 2012]. Patient visits to attending psychiatrists were scheduled at baseline, 3rd and 8th week. HDRS-17 was deployed to assess clinical efficiency and Q-LES-Q-SF scale for life quality assessment. Resource use and costs were evidenced from the Clinic's electronic registry of discharge invoices [national currency 1 €≈115.85 CSD]. Societal perspective and time horizon of 14 weeks were adopted. Results No statistically significant difference in HDRS scores before and after introducing treatment [χ2=4.339; r=0.362]. QALY value increased by the following: 11.77 of the SSRI, 8.93 of the SNRI, and 12.54 of the heterocyclic antidepressant group. Mean ICERs were: SSRI to SNRI [-44,148 CSD/QALY]; SNRI to Heterocyclics [-45,716 CSD/QALY]; Heterocyclics to SSRI [-51,501 CSD/QALY]. Therapeutic response in increment free days: 28.69 days gained SSRI, 21.78 days SNRI, 30.59 days in heterocyclics. Incremental cost per additional depression free day gained was for: SSRI 346.38 CSD per day, SNRI 327.74 CSD, and heterocyclics 201.54 CSD. Conclusions This trial evidence elucidates that the heterocyclic antidepressants provide highest 'value for money' in QALYs for the depressive episode treatment. According to Incremental cost-effectiveness ratio calculations, heterocyclic antidepressant proved superior to other two options. Cost-effectiveness evaluations have heavier impact to clinical decision making with regards to major depressive disorder treatment in the absence of clear clinical superiority of any major pharmacological protocol. |
| first_indexed | 2024-12-11T06:12:50Z |
| format | Article |
| id | doaj.art-bf18e8817afe4809a88259652b34ee37 |
| institution | Directory Open Access Journal |
| issn | 2334-9492 2334-9492 |
| language | English |
| last_indexed | 2024-12-11T06:12:50Z |
| publishDate | 2015-01-01 |
| publisher | Srpsko lekarsko drustvo |
| record_format | Article |
| series | Hospital Pharmacology |
| spelling | doaj.art-bf18e8817afe4809a88259652b34ee372022-12-22T01:18:04ZengSrpsko lekarsko drustvoHospital Pharmacology2334-94922334-94922015-01-012123524510.5937/hpimj1501235J2334-94921501235JCost-effectiveness of depressive episode pharmacological treatmentJakovljević Mihajlo B.0Tetsuji Yamada1Ching Chia Chen2Stevanović Dejan S.3Jovanović Mirjana R.4Nikić-Đuričić Katarina D.5Rančić Nemanja K.6Savić Dejana M.7Biorac Nenad M.8Mihajlović Goran S.9Janković Slobodan M.10University of Kragujevac, Faculty of Medicine, Kragujevac, SerbiaDepartment of Economics, Center for Children and Childhood Studies, Rutgers University, the State University of New Jersey, U.S.A.Department of Epidemiology & Community Health, School of Health Sciences & Practice, New York Medical College, U.S.A.University of Belgrade, Faculty of Medicine - Institute of Neurology and Psychiatry for Children and Youth, Belgrade, SerbiaPsychiatric Clinic, University Clinical Center KragujevacPsychiatric Clinic, University Clinical Center KragujevacCentre for Clinical Pharmacology, Medical Faculty, Military Medical Academy University of Defence, BelgradeUniversity of Kragujevac, Faculty of Medicine, Kragujevac, SerbiaPrimary Care Facility, SvilajnacPsychiatric Clinic, University Clinical Center KragujevacUniversity of Kragujevac, Faculty of Medicine, Kragujevac, SerbiaBackground and Objectives There is a paucity of published cost-effectiveness studies of alternative scenarios in depressive episode acute medical care in Eastern European populations. Methods Prospective cost-effectiveness analysis was conducted on 65 depressive patients in a large university clinic [May 2010-February 2012]. Patient visits to attending psychiatrists were scheduled at baseline, 3rd and 8th week. HDRS-17 was deployed to assess clinical efficiency and Q-LES-Q-SF scale for life quality assessment. Resource use and costs were evidenced from the Clinic's electronic registry of discharge invoices [national currency 1 €≈115.85 CSD]. Societal perspective and time horizon of 14 weeks were adopted. Results No statistically significant difference in HDRS scores before and after introducing treatment [χ2=4.339; r=0.362]. QALY value increased by the following: 11.77 of the SSRI, 8.93 of the SNRI, and 12.54 of the heterocyclic antidepressant group. Mean ICERs were: SSRI to SNRI [-44,148 CSD/QALY]; SNRI to Heterocyclics [-45,716 CSD/QALY]; Heterocyclics to SSRI [-51,501 CSD/QALY]. Therapeutic response in increment free days: 28.69 days gained SSRI, 21.78 days SNRI, 30.59 days in heterocyclics. Incremental cost per additional depression free day gained was for: SSRI 346.38 CSD per day, SNRI 327.74 CSD, and heterocyclics 201.54 CSD. Conclusions This trial evidence elucidates that the heterocyclic antidepressants provide highest 'value for money' in QALYs for the depressive episode treatment. According to Incremental cost-effectiveness ratio calculations, heterocyclic antidepressant proved superior to other two options. Cost-effectiveness evaluations have heavier impact to clinical decision making with regards to major depressive disorder treatment in the absence of clear clinical superiority of any major pharmacological protocol.http://scindeks-clanci.ceon.rs/data/pdf/2334-9492/2015/2334-94921501235J.pdfdepressive episodecost-evaluation and assessmentSSRISNRIheterocyclic antidepressants |
| spellingShingle | Jakovljević Mihajlo B. Tetsuji Yamada Ching Chia Chen Stevanović Dejan S. Jovanović Mirjana R. Nikić-Đuričić Katarina D. Rančić Nemanja K. Savić Dejana M. Biorac Nenad M. Mihajlović Goran S. Janković Slobodan M. Cost-effectiveness of depressive episode pharmacological treatment Hospital Pharmacology depressive episode cost-evaluation and assessment SSRI SNRI heterocyclic antidepressants |
| title | Cost-effectiveness of depressive episode pharmacological treatment |
| title_full | Cost-effectiveness of depressive episode pharmacological treatment |
| title_fullStr | Cost-effectiveness of depressive episode pharmacological treatment |
| title_full_unstemmed | Cost-effectiveness of depressive episode pharmacological treatment |
| title_short | Cost-effectiveness of depressive episode pharmacological treatment |
| title_sort | cost effectiveness of depressive episode pharmacological treatment |
| topic | depressive episode cost-evaluation and assessment SSRI SNRI heterocyclic antidepressants |
| url | http://scindeks-clanci.ceon.rs/data/pdf/2334-9492/2015/2334-94921501235J.pdf |
| work_keys_str_mv | AT jakovljevicmihajlob costeffectivenessofdepressiveepisodepharmacologicaltreatment AT tetsujiyamada costeffectivenessofdepressiveepisodepharmacologicaltreatment AT chingchiachen costeffectivenessofdepressiveepisodepharmacologicaltreatment AT stevanovicdejans costeffectivenessofdepressiveepisodepharmacologicaltreatment AT jovanovicmirjanar costeffectivenessofdepressiveepisodepharmacologicaltreatment AT nikicđuricickatarinad costeffectivenessofdepressiveepisodepharmacologicaltreatment AT rancicnemanjak costeffectivenessofdepressiveepisodepharmacologicaltreatment AT savicdejanam costeffectivenessofdepressiveepisodepharmacologicaltreatment AT bioracnenadm costeffectivenessofdepressiveepisodepharmacologicaltreatment AT mihajlovicgorans costeffectivenessofdepressiveepisodepharmacologicaltreatment AT jankovicslobodanm costeffectivenessofdepressiveepisodepharmacologicaltreatment |