Cost-effectiveness of venlafaxine for the treatment of major depression in hospitalized patients.

The economic burden of depression is often underestimated, especially when both the direct and indirect costs of treating the disease are considered. The costs associated with antidepressant drug therapy are often the focus of efforts to reduce overall treatment costs, but in actuality they represent only 10% of the overall economic costs of depression. Thus, in analyses of the costs of depression, other factors-including hospitalization, physician costs, monitoring, and indirect costs associated with lost productivity and comorbidity-are important. Economic assessments comparing different antidepressant classes have often found that newer antidepressants are more cost-effective than older, less expensive drugs because of improved tolerability or efficacy. Venlafaxine represents the newest class of antidepressants and offers potential pharmacologic benefits, including early onset of action, dose flexibility, broad range of activity, and improved tolerance. In one analysis that used the results from a study of 67 hospitalized depressed patients, venlafaxine was estimated to result in a cost savings of 11.3% versus fluoxetine. These findings support the concept that the overall costs of depression are more important than the drug costs in determining the cost-effectiveness of therapy.