Skip to main content
Log in

Cost-effectiveness of outpatient treatment in depressive patients with escitalopram in Germany

  • Original papers
  • Published:
The European Journal of Health Economics Aims and scope Submit manuscript

Abstract

We investigated the cost-effectiveness of escitalopram (10 mg daily dose) vs. venlafaxine XR (75 mg daily dose) in a German outpatient setting for the treatment of unipolar depression (MADRS score 20–34) over a period of 70 days. To assess the cost effectiveness of the two substances we combined data from physician’s surveys and clinical response data; cost-effectiveness was calculated using a Markov model. In a second step we considered the therapeutic decisions of the attending physicians. Cost-effectiveness was indicated as costs per successfully treated patient. Escitalopram demonstrated a more favorable cost-effectiveness ratio than venlafaxine XR. The analysis of treatment patterns showed that attending physicians intervene fairly early if the chosen therapy is ineffective. Additional costs for the use of venlafaxine XR over those of escitalopram were estimated from €7,446 to €9.836 per successfully treated per patient. Hence escitalopram may be a cost-effective alternative to venlafaxine XR in outpatient care setting in Germany.

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

Access this article

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

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Andersson IM, Nutt DJ, Deakin JFM (2000) Evidence-based guidelines for treating depressive disorders with antidepressants: a revision of the 1993 British Association for Psychopharmacology guidelines. J Psycholpharmacol 14:3–20

    Google Scholar 

  2. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, edn 4. American Psychiatric Association: Washington

    Google Scholar 

  3. Angst J, Gamma A, Gastpar M, Lépine JP, Mendlewicz J, Tylee A (2002) Gender differences in depression: epidemiological findings from the European DEPRES I, II studies. Eur Arch Psychiatry Clin Neurosci 252:201–209

    Article  PubMed  Google Scholar 

  4. Arzneimittelkommission der deutschen Ärzteschaft (1997) Empfehlungen Therapie Depression. Arzneimittelkommission der deutschen Ärzteschaft

  5. Bielski RJ, Ventura D, Chang C-C (2004) A double-blind comparison of escitalopram and venlafaxine extended release in the treatment of major depressive disorder. J Clin Psychol 65:1190–1196

    Google Scholar 

  6. Burke WJ, Kratochvil J (2002) Stereoisomers in psychiatry: the case of escitalopram. Prim Care Comp J Clin Psychiatry 4:20–24

    Google Scholar 

  7. Croom KF, Plosker GL (2003). Escitalopram—a pharmacoeconomic review of its use in depression. Pharmacoeconomics 21:1185–1209

    PubMed  Google Scholar 

  8. Deutsches Institut für Medizinische Information und Dokumentation (2004) ATC/DDD-GM Richtlinien (Version 2004). http://www.dimdi.de/dynamic/de/klassi/download/atc1/index.html (accessed 28 September 2004)

  9. Entsuah R, Huang H, Willard LB (2002) Venlafaxine and SSRIs: pooled remission analysis (mega-analysis of 31 studies of >7000 patients). Poster presented at the 18th World Congress of Psychotherapy, Trondheim, 14–18 August

    Google Scholar 

  10. Fritze J (2004) Psychopharmaka-Verordnungen: Ergebnisse und Kommentare zum Arzneiverordnungsreport 2003. Psychoneuroendocrinology 30:280–284

    Google Scholar 

  11. Fritze J, Saß H, Schmauß M (2001) Befragung der Fachgesellschaften durch den Sachverständigenrat für die Konzertierte Aktion im Gesundheitswesen zur Frage von Über-, Unter- und Fehlversorgung: Stellungnahme der Deutschen Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde (DGPPN). http://www.dgppn.de

  12. Jacobi F, Höfler M, Meister W, Wittchen HU (2002) Prävalenz, Erkennens- und Verschreibungsverhalten bei depressiven Syndromen: eine bundesdeutsche Hausarztstudie. Nervenarzt 73:651–658

    Article  PubMed  Google Scholar 

  13. Maier W (2004) Genetik der Depression. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 47:487–492

    Article  Google Scholar 

  14. Montgomery SA, Åsberg M (1979) A new depression scale designed to be sensitive to change. Br J Psychiatry 134:382–389

    PubMed  Google Scholar 

  15. Montgomery SA, Huuson AK, Bothmer J (2004) A randomised study comparing escitalopram with venlafaxine XR in primary care patients with major depressive disorder. Neuropsychobiology 50:57–64

    Article  PubMed  Google Scholar 

  16. Sachverständigenrat für die konzertierte Aktion im Gesundheitswesen (2001) Gutachten Bedarfsgerechtigkeit und Wirtschaftlichkeit, vol III

  17. Schulenburg JM von der, Mittendorf, T, Volmer, T et al (2005) The health economics handbook. Adis International: Munich

    Google Scholar 

  18. Statistisches Bundesamt (1998) Gesundheitsbericht für Deutschland. Statistisches Bundesamt: Wiesbaden

    Google Scholar 

  19. Thase ME, Entsuah AR, Rudolph RL (2001) Remission rates during treatment with venlafaxine or selective serotonin reuptake inhibitors. Br J Psychiatry 178:234–241

    Article  PubMed  Google Scholar 

  20. WHO (2001) The world health report 2001: mental health: new understanding, new hope. WHO

  21. WHO (2004) ICD-10. The international statistical classification of diseases and related health problems, tenth revision. http://www.who.int/whosis/icd10/ (accessed 28 September 2004)

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Werner Kulp.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kulp, W., von der Schulenburg, JM.G. & Greiner, W. Cost-effectiveness of outpatient treatment in depressive patients with escitalopram in Germany. Eur J Health Econ 6, 317–321 (2005). https://doi.org/10.1007/s10198-005-0306-1

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10198-005-0306-1

Keywords

Navigation