BACKGROUND: The cost-effectiveness of tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) has not been compared in a prospective study in primary care. AIMS: To determine the relative cost-effectiveness of TCAs, SSRIs and lofepramine in UK primary care. METHOD: An open-label, three-arm randomised trial with a preference arm. Practitioners referred 327 patients with incident depression. RESULTS: No significant differences were found in effectiveness or cost-effectiveness. The numbers of depression-free weeks over 12 months (on the Hospital Anxiety and Depression Scale) were 25.3 (95% CI 21.3-29.0) for TCAs, 28.3 (95% CI 24.3-32.2) for SSRIs and 24.6 (95% CI 20.6-28.9) for lofepramine. Mean health service costsper patient were pound 762 (95% CI 553-1059) for TCAs, pound 875 (95% CI 675-1355) for SSRIs and pound 867 (95% CI 634-1521) for lofepramine. Cost-effectiveness acceptability curves suggested SSRIs were most cost-effective (with a probability of up to 0.6). CONCLUSIONS: The findings support a policy of recommending SSRIs as first-choice antidepressants in primary care.
RCT Entities:
BACKGROUND: The cost-effectiveness of tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) has not been compared in a prospective study in primary care. AIMS: To determine the relative cost-effectiveness of TCAs, SSRIs and lofepramine in UK primary care. METHOD: An open-label, three-arm randomised trial with a preference arm. Practitioners referred 327 patients with incident depression. RESULTS: No significant differences were found in effectiveness or cost-effectiveness. The numbers of depression-free weeks over 12 months (on the Hospital Anxiety and Depression Scale) were 25.3 (95% CI 21.3-29.0) for TCAs, 28.3 (95% CI 24.3-32.2) for SSRIs and 24.6 (95% CI 20.6-28.9) for lofepramine. Mean health service costs per patient were pound 762 (95% CI 553-1059) for TCAs, pound 875 (95% CI 675-1355) for SSRIs and pound 867 (95% CI 634-1521) for lofepramine. Cost-effectiveness acceptability curves suggested SSRIs were most cost-effective (with a probability of up to 0.6). CONCLUSIONS: The findings support a policy of recommending SSRIs as first-choice antidepressants in primary care.
Authors: Katerina Papageorgiou; Karin M Vermeulen; Maya J Schroevers; Erik Buskens; Adelita V Ranchor Journal: Health Qual Life Outcomes Date: 2013-07-26 Impact factor: 3.186
Authors: Joshua E J Buckman; Rob Saunders; Zachary D Cohen; Katherine Clarke; Gareth Ambler; Robert J DeRubeis; Simon Gilbody; Steven D Hollon; Tony Kendrick; Edward Watkins; Ian R White; Glyn Lewis; Stephen Pilling Journal: Wellcome Open Res Date: 2020-04-01
Authors: Joshua E J Buckman; Rob Saunders; Zachary D Cohen; Phoebe Barnett; Katherine Clarke; Gareth Ambler; Robert J DeRubeis; Simon Gilbody; Steven D Hollon; Tony Kendrick; Edward Watkins; Nicola Wiles; David Kessler; David Richards; Deborah Sharp; Sally Brabyn; Elizabeth Littlewood; Chris Salisbury; Ian R White; Glyn Lewis; Stephen Pilling Journal: Psychol Med Date: 2021-04-14 Impact factor: 7.723