Suter K, Biddle A; International Society of Technology Assessment in Health Care. Meeting (19th : 2003 : Canmore, Alta.).
Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 2003; 19: abstract no. 35.
University of North Carolina at Chapel Hill, School of Pharmacy, 112 Walden Drive, Carrboro, 27510 NC USA Tel: (919) 928-8052, Fax: (919) 928-8052, E-mail: ksuter@unc.edu
OBJECTIVES: Major depression affects 10 to 35 percent of community dwelling elderly and left untreated, is associated with increased healthcare expenditures and risk of non-suicide mortality. Pharmacotherapy treatment of depression in the elderly warrants special consideration due to pharmacokinetic changes and polypharmacy. The objective of this study was to estimate the incremental cost-utility of sertraline (Zoloft, Pfizer) compared to bupropion SR (Wellbutrin SR, GlaxoSmithKline) in a population of community dwelling elderly with a diagnosis of major depression. METHODS: Decision tree modeling was used to calculate the incremental cost-utility for a hypothetical cohort of 1,000 elderly patients with diagnosed major depression over a time period of one-year from a societal perspective. Parameter estimates were obtained from a comprehensive review of published literature. Extensive sensitivity analysis was used to test each parameter. RESULTS: In the base-case analysis, bupropion SR treatment cost US$ 3.2 million and resulted in 777 quality-adjusted life years (QALYs), dominating sertraline treatment (US$3.5 million; 704 QALYs). One-way sensitive analysis yielded two sensitive utilities that were not sensitive in a multi-way analysis with each parameter tested at both the high or low end of their range. DISCUSSION: Both drugs, given their low potential for drug-drug interactions, time-released formulations, and lack of anticholinergic side effects, are appropriate for use in the elderly and may improve overall quality of life. The results suggest that bupropion SR may be a more cost-effective choice of antidepressant pharmacotherapy in an elderly population, especially in patients concerned about potential adverse sexual side effects.
Publication Types:
Keywords:
- Aged
- Antidepressive Agents
- Antidepressive Agents, Second-Generation
- Bupropion
- Costs and Cost Analysis
- Depression
- Depressive Disorder
- Depressive Disorder, Major
- Health Care Costs
- Humans
- Quality-Adjusted Life Years
- Sertraline
- economics
- therapy
- hsrmtgs
Other ID:
UI: 102275953
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