J. Borghi et Jf. Guest, Economic impact of using mirtazapine compared to amitriptyline and fluoxetine in the treatment of moderate and severe depression in the UK, EUR PSYCHIA, 15(6), 2000, pp. 378-387
This study modelled the economic impact of mirtazapine, compared to amitrip
tyline and fluoxetine, in the management of moderate and severe depression
in the UK, as well as the costs related to discontinuation of antidepressan
Decision models of the management of moderate and severe depression were de
veloped from clinical trial data, resource use obtained from interviews wit
h general practitioners and psychiatrists, and published literature, and we
re used to estimate the expected direct National Health Service (NHS) costs
of managing a patient with moderate or severe depression.
The expected cost of healthcare resource use attributable to managing a pat
ient suffering from moderate or severe depression who discontinues antidepr
essant treatment, irrespective of the initial treatment, was estimated to b
e pound 206 (range pound 50 to pound 504) over five months.
Using miriazapine instead of amitriptyline for seven months increases the p
roportion of successfully treated patients by 21% (from 19.2 to 23.2%) and
reduces the expected direct NHS cost by pound 35 per patient (from pound 44
8 to pound 413). Using mirtazapine instead of fluoxetine for six months inc
reases the proportion of successfully treated patients by 22% (from 15.6 to
19.1%), albeit for an additional cost to the NHS of pound 27 per patient (
from pound 394 to pound 420).
In conclusion, this study suggests that mirtazapine is a cost-effective ant
idepressant compared to amitriptyline and fluoxetine in the management of m
aderate and severe depression in the UK. (C) 2000 Editions scientifiques et
medicales Elsevier SAS.