Pharmacoeconomic comparisons of venlafaxine and mirtazapine in patients with treatment-resistant major depression

Abstract

Objective To compare the cost-effectiveness and cost-utility of venlafaxine and mirtazapine in patients with treatment-resistant major depression(TRD). Methods One hundred and five patients with TRD were enrolled in this study and grouped into venlafaxine treatment (n=50) and mirtazapine treatment (n=55) based on the double-blind randomization scheme generated by computer. The treatment costs of antidepressants during 8 weeks were calculated, the rates of clinical response and remission were taken as treatment effectiveness, and the quality-adjusted life years (QALYs) as treatment utility. The descriptive analysis and nonparametric test were used to compare the cost-effectiveness and cost-utility of different groups. Results During 8 weeks, the treatment cost of antidepressant was ￥1 396.44 for venlafaxine and ￥1 206.90 mirtazapine, and the difference between two groups was ￥189.54. The cost-effectiveness ratios between venlafaxine and mirtazapine were very close (differed ￥0.06 for remission rate and ￥1.08 for response rate respectively). There was no significant difference for cost-utility ratios between two groups (physical functioning Z=-0.15, P>0.05; mental health Z=-0.54, P>0.05). Conclusion Both cost-effectiveness and cost-utility of venlafaxine in patients with TRD are close between venlafaxine and mirtazapine. Key words: Treatment-resistant major depression; Venlafaxine; Mirtazapine; Cost-effectiveness; Cost-utility