A clinical- and cost-effectiveness comparison of venlafaxine and selective serotonin reuptake inhibitors (SSRIs) in the management of patients with major depressive disorder from the perspective of an Austrian sickness fund

Summary

This study evaluated the relative clinical-and cost-effectiveness of venlafaxine (Efectin®, Wyeth Pharmaceuticals, Austria) extended release (ER), venlafaxine instant release (IR) and selective serotonin reuptake inhibitors (SSRIs) in the treatment of major depressive disorder. The study took an Austrian sickness fund perspective and the evaluation originally formed part of a reimbursement submission of venlafaxine ER to the Hauptverband — an umbrella organisation representing the Austrian sickness funds.

At the time of the submission venlafaxine IR was reimbursed but published data and clinical practice suggested that it might be clinically inferior, less convenient and less acceptable to patients than the newer ER formulation. We believe this is the first study to directly compare the two venlafaxine formulations.

Major depressive disorder is a serious mental illness associated with considerable morbidity and a significant economic burden. An extensive literature review was carried out to retrieve the relevant clinical data and a meta-analysis of the homogeneous data was undertaken to establish the most clinically effective first-line treatment. An Austrian Delphi panel was used to provide treatment pattern data and to estimate outcomes for patients undergoing further lines of treatment. A 16-week time horizon was adopted and decision analysis was employed to model the cost-effectiveness of the respective agents.