Skip to main content
SpringerLink
Log in

A Critical Review of Published Economic Modelling Studies in Depression

  • Review Article
  • Published:
PharmacoEconomics Aims and scope Submit manuscript

Abstract

Depression is a very costly chronic disease. An important cost driver is treatment failure caused by patient noncompliance due, in part, to the adverse effects of medications. Additionally, inadequate duration of therapy and inappropriate medication switching contribute to the high cost of treatment. With the epidemiological data for depression demonstrating a rise in both incidence and prevalence over the last 20 years, and the fact that many of the newer antidepressants will see patent expiry in the near future, previous antidepressant cost-effectiveness scenarios are likely to change. As economic models play an increasingly important role in therapeutic decision-making, clinicians are encouraged to understand the strategies and methods involved in modelling antidepressant therapy.

The aim of this review of the literature and synthesis of the various techniques important to the modelling of antidepressant therapies is for the practitioner to gain an increased understanding of the modelling methods previously utilised and be in a position to better evaluate future health economic models for the treatment of depression.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Table II
Fig. 1
Table III
Table IV
Table V
Table VI
Table VII

Similar content being viewed by others

Notes

  1. Someoftheexamineditems(e.g.basecasereference) were explained in Hatziandreu et al.,[8] and are evaluated in section 1.6.The author did state that the decision model in this article was based on the previous model,and cited this reference.

References

  1. Greenberg PE, Stiglin LE, Finkelstein SN. The economic burden of depression in 1990. J Clin Psychiatry 1993; 54: 405–18

    Google Scholar 

  2. Stoudemire A, Frank R, Hedemark N, et al. The economic burden of depression. Gen Hosp Psychiatry 1986; 8: 387–94

    Article  PubMed  CAS  Google Scholar 

  3. Rice DP, Miller LS. The economic burden of affective disorders. Br J Psychiatry 1995; 166: 34–42

    Google Scholar 

  4. West R. Depression. London: Office of Health Economics, 1992

    Google Scholar 

  5. Canadian Coordinating Office for Health Technology Assessment. Selective serotonin reuptake inhibitors (SSRIs) for major depression. Part 1. Evaluation of the clinical literature. Ottawa: Canadian Coordinating Office for Health Technology Assessment, 1997

    Google Scholar 

  6. Canadian Coordinating Office for Health Technology Assessment. Selective serotonin reuptake inhibitors (SSRIs) for major depression. Part 2. The cost-effectiveness of SSRIs in the treatment of depression. Ottawa: Canadian Coordinating Office for Health Technology Assessment, 1997

    Google Scholar 

  7. Nuijten MJ, Hardens M, Souetre E. A Markov process analysis comparing the cost efficacy of maintenance therapy with citalopram versus standard therapy in major depression. Pharmacoeconomics 1995; 8: 159–68

    Article  PubMed  CAS  Google Scholar 

  8. Hatziandreu EJ, Brown RE, Revicki DA, et al. Cost utility of maintenance treatment of recurrent depression with sertraline versus episodic treatment with dothiepin. Pharmacoeconomics 1994; 5: 249–64

    Article  PubMed  CAS  Google Scholar 

  9. Revicki DA, Brown RE, Keller MB, et al. Cost-effectiveness of newer antidepressants compared with tricyclic antidepressants in managed care settings. J Clin Psychiatry 1997; 58: 47–58

    Article  PubMed  CAS  Google Scholar 

  10. Bentkover JD, Feighner JP. Cost analysis of paroxetine versus imipramine in major depression. Pharmacoeconomics 1995; 8: 223–32

    Article  PubMed  CAS  Google Scholar 

  11. Dunbar GC, Cohn JB, Fabre LF, et al. A comparison of paroxetine, imipramine and placebo in depressed outpatients. Br J Psychiatry 1991; 159: 394–8

    Article  PubMed  CAS  Google Scholar 

  12. Simon GE, Von Korff M, Heiligenstein JH, et al. Initial antidepressant choice in primary care: effectiveness and cost of fluoxetine vs tricyclic antidepressants. JAMA 1996; 275: 1897–902

    Article  PubMed  CAS  Google Scholar 

  13. Canadian Coordinating Office for Health Technology Assessment. Guidelines for economic evaluation of pharmaceuticals: Canada. 2nd ed. Ottawa: Canadian Coordinating Office for Health Technology Assessment, 1997

  14. Commonwealth Department of Human Services and Health. Guidelines for the pharmaceutical industry on preparation of submissions to the pharmaceutical benefits advisory committee. Canberra: Commonwealth Department of Human Services and Health, 1995

    Google Scholar 

  15. Anton SF, Revicki DA. The use of decision analysis in the pharmacoeconomic evaluation of an antidepressant: a cost-effectiveness study of nefazodone. Psychopharmacol Bull 1995; 31: 249–58

    PubMed  CAS  Google Scholar 

  16. Hylan TR, Kotsanos JG, Anderson JS, et al. Comparison of a decision analytical model with results from a naturalistic economic clinical trial: an application to evaluating alternative antidepressants. Am J Manag Care 1996; 2: 1211–23

    Google Scholar 

  17. Einarson TR, Arikian SR, Sweeny S, et al. A model to evaluate the cost-efficacy of oral therapies in the management of patients with major depressive disorders. Clin Ther 1995; 17: 136–53

    Article  PubMed  CAS  Google Scholar 

  18. Einarson TR, Addis A, Iskedjian M. Pharmacoeconomic analysis of venlafaxine in the treatment of major depressive disorder. Pharmacoeconomics 1997; 12: 286–96

    Article  PubMed  CAS  Google Scholar 

  19. Kind P, Sorensen J. Modeling the cost-efficacy of the prophylactic use of SSRIs in the treatment of depression. Int Clin Psychopharmacol 1995; 10: 41–8

    Article  PubMed  Google Scholar 

  20. Revicki DA, Brown RE, Palmer W, et al. Modeling the cost efficacy of antidepressant treatment in primary care. Pharmacoeconomics 1995; 8: 524–40

    Article  PubMed  CAS  Google Scholar 

  21. Drug Topics Red Book. Montvale (NJ): Medical Economics Company, 1998

    Google Scholar 

  22. Frank E, Kupfer DJ, Wagner EF, et al. Efficacy of interpersonal psychotherapy as a maintenance treatment of recurrent depression: contributing factors. Arch Gen Psychiatry 1991; 48: 1053–9

    Article  PubMed  CAS  Google Scholar 

  23. Klerman GL, Weissman MM. The course, morbidity and costs of depression. Arch Gen Psychiatry 1992; 49: 831–4

    Article  PubMed  CAS  Google Scholar 

  24. Prien RF, Kupfer DJ. Continuation drug therapy for major depressive episodes: how long should it be maintained? Am J Psychiatry 1986; 143: 18–23

    PubMed  CAS  Google Scholar 

  25. Agency for Health Care Policy and Research (AHCPR). Clinical practice guidelines for depression (‘depression in primary care’ guidelines), 1998. Available from: http://www.ahcpr.gov/clinic/medtep/resource.htm [Accessed 2000 Apr 13]

  26. Montgomery SA, Henry J, McDonald G, et al. Selective serotonin reuptake inhibitors: meta-analysis of discontinuation rates. Int Clin Psychopharmacol 1994; 9: 47–53

    Article  PubMed  CAS  Google Scholar 

  27. Doubilet P, Begg CB, Weinstein MC, et al. Probabilistic sensitivity analysis using Monte Carlo simulation: a practical approach. Med Decis Making 1985; 5: 157–77

    Article  PubMed  CAS  Google Scholar 

  28. Medical Information Management Service (MIMS) [1994 data]. London: MediMedia International, 1994

    Google Scholar 

  29. Revicki DA, Wood M. Patient-assigned health state utilities for depression-related outcomes: differences by depression severity and antidepressant medication. J Affect Disord 1998; 48: 25–36

    Article  PubMed  CAS  Google Scholar 

  30. Stoner SC, Marken PA, Watson WA, et al. Antidepressant overdoses and resultant emergency department services: the impact of SSRIs. Psychopharmacol Bull 1997; 33: 667–70

    PubMed  CAS  Google Scholar 

  31. Kupfer DJ. Long-term treatment of depression. J Clin Psychiatry 1991; 52: 28–34

    PubMed  Google Scholar 

  32. Copley-Merriman C, Lair TJ. Valuation of medical resource units collected in health economic studies. Clin Ther 1994; 16: 553–68

    PubMed  CAS  Google Scholar 

  33. SMLTREE generic software package, version 2.9. Roslyn (NY): Jim Hollenberg, 1989

  34. Physicians desk reference (PDR). Montvale (NY): Medical Economics Company, 1997

    Google Scholar 

  35. Celexa™ (citalopram HBr) [package insert]. St Louis (MO): Forrest Laboratories, Inc., 1998

    Google Scholar 

  36. Department of Health and Human Services. Approved drug products with therapeutic equivalence evaluations. 17th ed. Washington (DC): Department of Health and Human Services, Public Health Service, FDA, Division of Database Management, 1997

  37. Incidence and prevalence database (IPD), 1988. Available from: http://open.academic.N2K.com/p/P0465AA.htm [Accessed 2000 Apr 13]

  38. Kessler RC, McGonagle KA, Nelson CB, et al. Sex and depression in the National Comorbidity Survey II: cohort effects. J Affect Disord 1994; 30: 15–26

    Article  PubMed  CAS  Google Scholar 

  39. Doogan DP, Caillard V. Sertraline in the prevention of depression. Br J Psychiatry 1992; 160: 217–22

    Article  PubMed  CAS  Google Scholar 

  40. Mueller TI, Leon AC. Recovery, chronicity, and levels of psychopathology in major depression. Psychiatr Clin North Am 1996; 19: 85–102

    Article  PubMed  CAS  Google Scholar 

  41. Keller MB, Shapiro RW, Lavori PW, et al. Relapse in major depressive disorder: analysis with the life table. Arch Gen Psychiatry 1982; 39: 911–5

    Article  PubMed  CAS  Google Scholar 

  42. Song F, Freemantle N, Sheldon TA, et al. Selective serotonin reuptake inhibitors: meta-analysis of efficacy and acceptability. BMJ 1993; 306: 683–7

    Article  PubMed  CAS  Google Scholar 

  43. Anderson IM, Tomenson BM. Treatment discontinuation with selective serotonin reuptake inhibitors compared with tricyclic antidepressants: a meta-analysis. BMJ 1995; 310: 1433–8

    Article  PubMed  CAS  Google Scholar 

  44. Medispan™ database.Available from: http://www.medispan.com

  45. Price Probe™ database. Available from: http://www.firstdatabank.com/drug/nddf_product_line/software_products/price_probe/price_probe.htm

  46. First Databank database. Available from: http://www.firstdatabank.com

  47. Buxton MJ, Drummond MF, Van Hout BA, et al. Modeling in economic evaluation: an unavoidable fact of life. Health Econ 1997; 6: 217–27

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

Dr Jones is a psychopharmacy research fellow at the Western Missouri Mental Health Center in Kansas City, Missouri, and was a Pharm.D. student completing a rotation in pharmacoeconomics in the Outcomes Research Division of Parke-Davis Pharmaceuticals, Ann Arbor, Michigan at the time of data compilation. Dr Cockrum is Senior Outcomes Researcher with Alcon Laboratories, Inc., Fort Worth, Texas, and was a pharmacoeconomist in the Outcomes Research Division of Parke-Davis Pharmaceuticals at the time of data compilation.

Author information

Authors and Affiliations

  1. School of Pharmacy, Psychopharmacy Research and Education Program, University of Missouri-Kansas City, M3-C19 Medical School Building, 2411 Holmes Street, Kansas City, MO, 64108-2792, USA

    Michael T. Jones

  2. Health Economics Department, Alcon Research, Inc., Fort Worth, Texas, USA

    Paul C. Cockrum

Authors
  1. Michael T. Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paul C. Cockrum
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jones, M.T., Cockrum, P.C. A Critical Review of Published Economic Modelling Studies in Depression. Pharmacoeconomics 17, 555–583 (2000). https://doi.org/10.2165/00019053-200017060-00003

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00019053-200017060-00003

Keywords

Search

Navigation