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Análisis de coste-efectividad de escitalopram comparado con citalopram en el tratamiento de pacientes con depresión mayor grave

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PharmacoEconomics Spanish Research Articles

Resumen

Objetivo: Realizar un análisis de coste-efectividad comparando escitalopram y citalopram en el tratamiento de la depresión mayor grave.

Metodología: Se ha adaptado un modelo de árbol de decisión, que representa el tratamiento de la depresión mayor grave, al contexto español. El modelo representa las opciones terapéuticas habituales, en el contexto sanitario español, para la población del estudio. El horizonte temporal del modelo es de 6 meses y calcula el cociente de coste-efectividad por paciente con remisión. Los datos de eficacia del modelo provienen de un ensayo clínico aleatorizado. Las pautas de tratamiento habituales en España han sido indicadas por varios especialistas médicos. La perspectiva del análisis es la del sistema sanitario y el año del análisis, 2005.

Resultados: El coste por paciente con remisión es de 951 € con escitalopram y de 992 € con citalopram. El coste por conseguir una remisión adicional mediante escitalopram respecto a citalopram se ha estimado en 353 €.

Conclusiones: El tratamiento con escitalopram, además de ser más eficaz que citalopram, presenta un perfil de eficiencia cuyos costes adicionales respecto de los costes de los tratamientos medios por remisión con citalopram son menores, por lo que su empleo estaría respaldado desde la perspectiva económica.

Abstract

Objective: To undertake a cost-effectiveness analysis of escitalopram versus citalopram for the treatment of severe depression.

Method: A decision tree model of the severe depression treatment has been adapted to the Spanish context. The model represents the standard treatment patterns in Spain for the study population. The time horizon of the model is 6 months and it computes estimates of the cost per patient with remission (successfully treated). The effectiveness data for the model come from a randomised trial. The current treatment patterns have been established according to the indications of a group of medical experts. The health system perspective was adopted for the analysis and the year for the cost data was 2005.

Results: The cost per controlled patient is 951 € with escitalopram and 992 € with citalopram. The incremental cost per succesfully treated patient with escitalopran compared to citalopram is 353 €. The sensitivity analyses show that these results were robust.

Conclusion: Escitalopram is a more efficacious treatment compared to citalo-pram and presents a profile of efficiency whose additional costs with respect to the average costs of the treatments per remision with citalopram are lower; thus the utilisation of escitalopram would be underpinned from the economic perspective.

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Authors and Affiliations

  1. Dpto. de Economía y Empresa, Universidad de La Rioja, c/ Cigüeña,60, 26004, Logroño. La Rioja, España

    María Velasco, Carmelo Juárez & Fernando Antoñanzas

  2. Asociación Científica Psicost, España

    Luis Salvador

Authors
  1. María Velasco
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  2. Luis Salvador
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  3. Carmelo Juárez
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  4. Fernando Antoñanzas
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Correspondence to Fernando Antoñanzas.

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Estudio patrocinado por Lundbeck S.A. y Almirall Prodesfarma S.A.

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Velasco, M., Salvador, L., Juárez, C. et al. Análisis de coste-efectividad de escitalopram comparado con citalopram en el tratamiento de pacientes con depresión mayor grave. Pharmacoecon. Span. Res. Artic. 3, 63–73 (2006). https://doi.org/10.1007/BF03320911

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