Randomized and parallel-group study of cost-effectiveness analysis of escitalopram and desvenlafaxine in moderate-to-severe depression

Abstract

Background: Cost-effectiveness analysis (CEA) measures costs and outcomes in monetary terms, it can be used to compare net benefits of all types of interventions. CEA is most important for chronic conditions such as depression requiring long-term/lifelong medications. Depression is a mood disorder affecting all age groups with a considerable impact on the quality of life. It imposes an economic burden on the individual, family, and society. Among antidepressants, selective serotonin reuptake inhibitors and serotonin-noradrenaline reuptake inhibitors are commonly preferred since they are well-tolerated and efficacious. As there are only few studies done in Indian population to compare the efficacy and tolerability of Escitalopram and Desvenlafaxine, and no CEA have been done to compare the cost-effectiveness of Escitalopram and Desvenlafaxine, the present study was taken up. Therefore, the present study was undertaken. Aims and Objectives: The aim of the study was to evaluate the cost-effectiveness of Escitalopram and Desvenlafaxine in the treatment of moderate-to-severe depression. Materials and Methods: A randomized, open-label, standard controlled, parallel-group, and 8-week study of CEA of Escitalopram and Desvenlafaxine was performed in 60 subjects with newly diagnosed moderate-to-severe depression. Clinical improvement was assessed using the montgomery and asberg depression rating scale (MADRS). CEA was analyzed using average cost-effectiveness ratio (ACER) and increment cost-effectiveness ratio (ICER). Results: Escitalopram and Desvenlafaxine showed a significant reduction in the total MADRS scores. Escitalopram showed a faster onset of action and was more efficacious than Desvenlafaxine in reducing depressive symptoms. ACER shows a lesser cost required for Escitalopram over Desvenlafaxine. Negative ICER and increment net benefit analysis demonstrate that Escitalopram is cost-effective versus Desvenlafaxine. Study drugs were well tolerated, with mild nausea in the Desvenlafaxine group. Conclusion: Escitalopram was more cost-effective in comparison to Desvenlafaxine in moderate to severe depression.