Abstract
BackgroundDuloxetine and venlafaxine extended release (venlafaxine XR) are SNRIs indicated for the treatment of MDD. This study addresses whether duloxetine and venlafaxine XR are interchangeable in their patterns of use with patients who are depressed or are used more selectively based on treatment history, background characteristics, and presenting symptoms.MethodsThis was a retrospective analysis of an administrative insurance claims database. We studied patients in managed care with major depressive disorder (MDD) treated with duloxetine or venlafaxine XR. Predictors of treatment and cost were assessed using Chi-square and logistic regression analyses of demographics and past-year medication use and comorbidities.ResultsPatients with MDD treated with duloxetine (n = 9,641) versus venlafaxine XR (n = 8,514) tended to be older, slightly more likely to be female, and treated by a psychiatrist (P < 0.0001). In the prior year, more duloxetine patients (vs. venlafaxine XR) received ≥3 unique antidepressants (20.8% vs. 16.6%), ≥3 unique pain medications (25.5% vs. 15.6%), and had ≥8 unique diagnosed comorbid medical and psychiatric conditions (38.6% vs. 29.1%). The prior 6-month total health care costs were $1,731 higher for duloxetine than for venlafaxine XR and declined for both medications in the 6 months after treatment began. Logistic regression analysis revealed that 61% of duloxetine patients and 61% of venlafaxine XR patients were predictable from prior patient and treatment factors.ConclusionsPatients with MDD treated with duloxetine tended to have a more complex and costly antecedent clinical presentation compared with venlafaxine XR patients, suggesting that physicians do not use the medications interchangeably.
Highlights
Duloxetine and venlafaxine extended release are serotonin norepinephrine-reuptake inhibitors (SNRIs) indicated for the treatment of major depressive disorder (MDD)
Other medication classes were prescribed to higher proportions of patients initiating treatment with duloxetine compared with venlafaxine XR during the year before the index date, including hypnotics (30% vs. 22%) and antiulcer (29% vs. 23%) medications (P < 0.0001 for each comparison)
A slightly higher proportion of patients in the duloxetine cohort in the previous year received ≥3 unique antidepressants (21% vs. 17%), and 26% of duloxetine patients received ≥3 unique pain medications compared with 16% for venlafaxine XR (P < 0.0001)
Summary
Duloxetine and venlafaxine extended release (venlafaxine XR) are SNRIs indicated for the treatment of MDD. This study addresses whether duloxetine and venlafaxine XR are interchangeable in their patterns of use with patients who are depressed or are used more selectively based on treatment history, background characteristics, and presenting symptoms. SNRIs may be more effective than SSRIs in ameliorating depressive symptoms in some circumstances [3,4,5], in achieving greater remission rates [6,7], and in secondline use after poor initial treatment response [8,9]. This study examines the differential realworld use and cost impact of the SNRIs duloxetine hydrochloride and venlafaxine hydrochloride extended release (venlafaxine XR) in the treatment of MDD
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.