Cost-Effectiveness Analysis of Clinical Commonly Used Drug Options in the Treatment of Moderate-Severe Depressive Disorder in China: A Decision Tree Model_Chinese Journal of Evidence-Based Medicine

Authors：

 LIUQiang , LIHong-chao ,  MAAi-xia

School of International Pharmacuetical Business, China Pharmacuetical University, Nanjing 211198, China;

Corresponding?author：

MAAi-xia, Email: ma86128@sina.com

Keywords：

Depression disorder; Decision tree model; Cost-effectiveness analysis; Antidepressants

DOI：

10.7507/1672-2531.20160097

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the cost effectiveness of four different mechanisms clinical commonly used antidepressants, namely, amitriptyline, escitalopram, mirtazapine and venlafaxine in the treatment of moderate-severe depressive disorder in China and to provide clinicians with some advice. Methods We carried out the cost-effectiveness analysis of four antidepressants by establishing a decision tree model. The parameters uncertainty in the model was estimated through one-way sensitivity analysis. Results In terms of average cost-effectiveness ratio (CER), amitriptyline’s was 45.24 RMB, which was the lowest. And the CERs of mirtazapine, escitalopram and venlafaxine were 273.71 RMB, 332.00 RMB and 716.58 RMB, respectively. While in terms of incremental cost-effectiveness ratio (ICER), venlafaxine was excluded as the dominated strategy. When the threshold value of willingness to pay (WTP) was less than 3?420.92 RMB, amitriptyline was the most cost-effective; when the threshold value ranges between 3?420.92 RMB and 4?200 RMB, mirtazapine was the most cost-effective; and when the threshold value was over 4?200 RMB, escitalopram was the most cost-effective. In the one-way sensitivity analysis, when we changed the four kinds of drugs costs within a certain range, the results was not changed with the change of venlafaxine’s cost but changed with the other three drugs costs. Conclusion Clinicians may choose the most cost-effective therapy according to patients’ different WTP values. We suggests that health care institutions should encourage the use of escitalopram clinically and provide subsidies for patients so as to increase the overall society benefit.

Citation： LIUQiang, LIHong-chao, MAAi-xia. Cost-Effectiveness Analysis of Clinical Commonly Used Drug Options in the Treatment of Moderate-Severe Depressive Disorder in China: A Decision Tree Model. Chinese Journal of Evidence-Based Medicine, 2016, 16(6): 628-634. doi: 10.7507/1672-2531.20160097 Copy

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1. ?Bland RC. Epidemiology of affective disorder: a review. Can J Psy-chiatry, 1997, 42(4): 367.
2. 舒良. 抑郁癥的評定與治療. 中華醫學雜志, 1999, 79(5): 398-400.
3. 趙靖平, 翟金國, 陳晉東, 等. 抑郁癥和精神分裂癥的疾病負擔研究. 中華醫學會精神病學分會第七屆學術年會組委會. 中華醫學會精神病學分會第七屆學術年會論文摘要集. 2006: 2.
4. 李凌江, 馬辛. 中國抑郁障礙防治指南. 第2版. 中華醫學電子音像出版社, 2015.
5. 周宇, 林蘭榮, 吳坤豐. 艾司西酞普蘭與文拉法辛治療抑郁障礙的成本-效果分析. 中國藥物經濟學, 2013, 8(4): 16-18.
6. 朱云澤. 三種抗抑郁藥物治療方案的成本-效果分析. 人人健康(醫學導刊), 2008, (5): 86.
7. 溫預關, 陳偉家, 王玲芝, 等. 三種抗抑郁藥治療抑郁癥的成本-效果分析. 中國藥業, 2003, 12(2): 68-69.
8. 許德河, 孫穎. 抗抑郁藥治療抑郁癥的成本-效果分析. 中國藥業, 2006, 15(17): 53-54.
9. 陳策, 陳光東, 土文珍, 等. 四種新型抗抑郁藥治療抑郁癥的成本-效果評價. 醫院管理論壇, 2014, 31(10): 39-41.
10. 尹榕, 劉曌, 張國楨, 等. Wingspan支架治療顱內動脈粥樣硬化性狹窄單組率的Meta分析. 中國循證醫學雜志, 2015, 15(3): 295-304.
11. Annemans L, Brignone M, Druais S, et al. Cost-Effectiveness Analysis of Pharmaceutical Treatment Options in the First-Line Management of Major Depressive Disorder in Belgium. PharmacoEconomics, 2014, 32(5): 479-493.
12. Ramsberg J, Asseburg C, Henriksson M. Effectiveness and cost-effectiveness of antidepressants in primary care a multiple treatment comparison meta-analysis and cost-effectiveness model. PLoS One, 2012, 7(8): e42003.

Chinese Journal of Evidence-Based Medicine

Cost-Effectiveness Analysis of Clinical Commonly Used Drug Options in the Treatment of Moderate-Severe Depressive Disorder in China: A Decision Tree Model

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