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Comparación de la efectividad con relación al coste del milnaciprán (un SNRI) con los TCA y los SSRI: un enfoque de modelado

Published online by Cambridge University Press:  12 May 2020

R. Dardennes ,
G. Berdeaux ,
A. Lafuma  and
F. Fagnani
R. Dardennes
Affiliation:
Universidad René-Descartes París V, Hospital Santa Ana, París
G. Berdeaux
Affiliation:
Pierre Fabre Médicament SA, Boulogne-Billancourt
A. Lafuma
Affiliation:
Cemka, Bourg-la-Reine, Francia
F. Fagnani
Affiliation:
Cemka, Bourg-la-Reine, Francia
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Resumen

Se utilizó un modelo de simulación basado en la teoría del análisis de decisiones clínicas para comparar la evolución y los costes de tratar a pacientes con episodio depresivo mayor utilizando un inhibidor selectivo de la recaptación de serotonina (SSRI) o un antidepresivo tricíclico (TCA) con milnaciprán (un inhibidor de la recaptación de serotonina y norepinefrina [SNRI]). Los datos clínicos utilizados se tomaron de meta-análisis publicados. Este análisis apoya: (1) una eficacia comparable del milnaciprán y los TCA con una mejor tolerancia, y (2) una ventaja del milnaciprán sobre los SSRI en cuanto a la eficacia, con una tolerancia comparable. Sobre la base de estos resultados, se construyó un árbol de decisión con la ayuda de un equipo de psiquiatras para proporcionar un modelo de la práctica clínica usual. Se obtuvieron estimaciones no disponibles en los estudios clínicos a partir del análisis de las publicaciones o del equipo de psiquiatras. La valoración económica se realizó según el punto de vista del fondo nacional de enfermedad francés (sécurité sociale) y la evaluación del gasto se limitó a los costes directos (hospitalizaciones, medicaciones antidepresivas, visitas y pruebas de laboratorio). Los resultados indican que el milnaciprán es una posibilidad efectiva con relación a su coste: el coste esperado del tratamiento por episodio depresivo es más bajo que el de una lista representativa francesa de TCA (un ahorro de 288 francos franceses) o el de los SSRI (uno de 961 francos franceses). La duración esperada de la remisión clínica es ligeramente más alta que con los comparadores. Los análisis de la sensibilidad apoyaron la solidez de estos resultados.

Keywords

coste y consecuenciasanálisis de la decisióndepresiónfarmacoeconomíainhibidor selectivo de la recaptación de serotoninainhibidor de la recaptación de serotonina y norepinefrinaantidepresivo tricíclico
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 7 , Issue 2 , March 2000 , pp. 79 - 90
Copyright
Copyright © European Psychiatric Association 2000

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Footnotes

Dardennes R, Berdeaux G, Lafuma A, Fagnani F. Comparison of the cost-effectiveness of milnacipran (a SNRI) with TCAs and SSRIs: a modeling approach. Eur Psychiatry 1999; 14-152-62.

References

Bibliografía

Aberg-Wistedt, A.Comparison between zimelidine and desipramine in endogenous depression: a cross-over study. Acta Psychiatr Scand 1982; 66: 129–38.CrossRefGoogle ScholarPubMed
Agence du Medicament. Fiches de Transparence. Agence du médicament CFES. París: Agence du médicament; 1994: 187.Google Scholar
Anderson, IM, Tomenson, BM. The efficacy of selective serotonin re-uptake inhibitors in depression: a metaanalysis of studies against tricyclic antidepressants J Psychopharmacology 1994; 8: 238–49.CrossRefGoogle Scholar
Angst, J.How recurrent and predictable is depressive illness? In: Montgomery, S, Rouillon, F, eds. Perspectives in psychiatry, vol. 3. Long-term treatment of depression. Toronto: John and Willey & Sons; 1992; 114.Google Scholar
Benkert, O, Grunder, G, Wetzel, H, Hackett, D. A randomized, double blind comparison of a rapidly escalating dose of venlafaxine and imipramine in inpatients with major depression and melancholia. J Psychiatr Res 1996; 30:441–51.CrossRefGoogle ScholarPubMed
Bentkover, JD, Feighner, JP. Cost analysis of paroxetine versus imipramine in major depression. Pharmacoeconomics 1995; 8: 223–32.CrossRefGoogle ScholarPubMed
Bland, RC, Newman, SC, Orn, H. Period prevalence of psychiatric disorder in Edmonton. Acta Psychiatr Scand 1988; 77: 33–42.CrossRefGoogle Scholar
Bland, RC, Orn, H, Newman, SC. Lifetime prevalence of psychiatric disorders in Edmonton. Acta Psychiatr Scand 1988; 77: 24–32.CrossRefGoogle Scholar
Blazzer, DG, Kessler, RC, Gonagle, MC, Swartz, KA. The prevalence and distribution of major depression in a national community sample: the national comorbidity survey. Am J Psychiatry 1994; 154: 979–86.Google Scholar
Clerc, GE, Ruimy, P, Verdeau-Palles, J. A double blind comparison of venlafaxine and fluoxetine in patients hospitalized for major depression and melancholia. The venlafaxine inpatient study group. Int Clin Psychopharmacol 1994; 9: 130–43.Google ScholarPubMed
Diereck, M, Ravizza, L, Realini, R, Martin, A. A double blind comparison of venlafaxine and fluoxetine for the treatment of major depression in outpatients. Prog Neuropsychopharrmcol Biol Psychiatry 1996; 20: 57–71.Google Scholar
Donoghue, JM, Tylee, A. The treatment of depression: prescribing patterns of antidepressants in primary care in the UK. Br. J Psychiatry 1996; 168: 164–8.CrossRefGoogle ScholarPubMed
Doogan, DP, Caillard, V. Sertraline in the prevention of depression. Br J Pschiatry 1992; 160: 217–22.CrossRefGoogle ScholarPubMed
Einarson, Tr, Srikian, S, Sweeney, S, Doyle, J. A model to evalúate the cost-effectiveness of oral therapies in the management of patients with major depressive disorders. Clin Therapeutics 1995; 17: 136–53.CrossRefGoogle Scholar
Emrich, H, Berger, M, Riemann, D, von Zerssen, D. Serotonin re-uptake inhibition versus norepinephrine reuptake inhibition: a double-blind differential therapeutic study with fluvoxamine and oxaprotiline in endogenous and neurotic depressives. Pharmacopsychiatrica 1987; 20: 60–3.CrossRefGoogle Scholar
Favarelli, C, Ambonetti, A, Pallanti, S, Pazzagli, A. Depressive relapses and incomplete recovery from Índex episode. Am J Psychiatry 1986; 143: 888–91.Google Scholar
Guidelines and recommendations for French pharma-coeconomic studies. Collége des économiste de la santé. París: La lettre du collége; April 1997.Google Scholar
Johnson, DAW. A study of the use of antidepressant medication in general practice. Br J Psychiatry 1974; 125: 186–92.CrossRefGoogle ScholarPubMed
Johnson, DAW. Treatment of depression in general practice. Br Med J 1973; 2: 18–20.CrossRefGoogle ScholarPubMed
Jonsson, B, Bebbington, PE. What price deppression? The cost of depression and the cost-effectiveness of pharmacological treatment. Br J Psychiatry 1994; 164: 665–73.CrossRefGoogle Scholar
Katon, W, von Korff, M, Lin, E, Bush, T, Omel, J. Adequacy and duration of antidepressant treatment in primary care. Med Care 1992; 30: 67–76.CrossRefGoogle ScholarPubMed
Kay, DWK, Garside, RF, Poy, JR. Beamish, P. Endogenous and neurotic syndromes of depression: a 5 to 7 years follow-up of 104 cass. Br J Psychiatry 1969; 115: 389–99.CrossRefGoogle Scholar
Keller, MB, Klerman, GL, Lavori, PW, Fawcett, JA, Coryell, W, Endicott, J. Treatment received by depressed patients. JAMA 1982; 248: 1848–55.CrossRefGoogle ScholarPubMed
Keller, MB, Lavori, PW, Klerman, GL, Andreasen, NC, Endictt, J, Coryell, W, et al. Low levels and lack of predictors of somatotherapy and psychotherapy received by depressed patients. Arch Gen Psychiatry 1986; 43: 458–66.CrossRefGoogle ScholarPubMed
Kotin, J, Post, RM, Goodwin, FK. Drug treatment of depressed patients referred for hospitalization. Am J Psychiatry 1973; 130: 1139–41.CrossRefGoogle ScholarPubMed
Kovess, V, Gysens, S, Chanoit, PF. Une enquéte de santé mentale: l'enquéte de santé des Franciliens. Ann Med Psychol 1993; 151: 624–8.Google Scholar
Lapierre, Y, Bentkover, J, Schainbaum, S, Manners, S. Direct cost of depression: analysis of treatment costs of paroxetine versus imipramine in Cañada. Can J Psychiatry 1995; 40: 370–7.CrossRefGoogle ScholarPubMed
LePape, A, Lecomte, T. Aspects socio-économiques de la dépression. París: CREDES; 1996: 83.Google Scholar
LePen, C, Levy, E, Ravily, V, Beuzen, JN, Meurgey, F. The cost of treatment dropout in depression. A cost-benefit analysis of fluoxetine vs. tricyclics. J Affect Disord 1994; 31: 1–18.CrossRefGoogle Scholar
Lecomte, T. Aspects socio-économiques de la dépression. Ann Med Interne 1989; 140: 687–90.Google Scholar
Lepine, JP, Lellouch, J, Lovell, A, Téhérani, M, Ha, C, Verdier-Taillefer, MH, et al. Anxiety and depressive disorders in a French population: methodology and preliminary results. Psychiat Psychobiol 1989; 4: 267–74.Google Scholar
Lingjaerde, O, Bratfos, O, Bratlid, T, Hang, J. A double-blind comparison of zimelidine and desipramine in endogenous depression. Acta Psychiatr Scand 1983; 68: 22–30.CrossRefGoogle ScholarPubMed
Maj, M, Veltro, F, Pirozzi, R, Lobrace, S, Magliano, L. Patterns of recurrence of illness after recovery from an episode of major depression: a prospective study. Am J Psychiatry 1992; 149: 795–800.Google Scholar
Main Economic Indicators. Organisation de coopérative et de développmenet economique. París: OECD; 1996.Google Scholar
Ministère des Affaires Sociales et de l'Intégration. Les soins hospitaliers en France. Clientéle, pathologies tríté-es en cours séjour. París: la documentation Française; 1992: 247.Google Scholar
Montgomery, SA, Dufour, H, Brion, S, Gailledreau, J, Laqueille, X, Ferrey, G, et al. The prophylactic efficacy of Fluoxetine in unipolar depression. Br J Psychiatry 1988; 153 Suppl 3: 69–76.CrossRefGoogle Scholar
Nomenclature générale des actes professionels. París: Union des Caisses Nationales de Sécurité Sociales; 1996: 106.Google Scholar
Nuijten, MJC, Hardens, M, Souetre, E. A markov process analysis comparing the cost-effectiveness of maintenance therapy with citalopram versus standard therapy in major depression. Pharmacoeconomics 1995; 8: 159–68.CrossRefGoogle ScholarPubMed
Nystrom, C, Hallstrom, T. Comparison between serotonin and norepinephrine re-uptake blocker in the treatment of depressed outpatients: a crossover study Acta Psychiatr Scand 1987; 75: 377–82.CrossRefGoogle Scholar
Nystrom, C, Hallstrom, T. Double-blind comparison between serotonin and norepinephrine re-uptake blocker in the treatment of depressed patients: clinical aspects. Acta Psychiatr Scand 1985; 72: 6–15.CrossRefGoogle Scholar
Perry, PJ. Pharmacotherapy for major depression with melancolic features: relative efficacy of tricyclic versus selective serotonin re-uptake inhibitors antidepressants. J Affect Disord 1996; 39: 1–6.CrossRefGoogle Scholar
Puech, A, Montgomery, S, Prost, JF, Solles, A, Briley, M. Milnacipran, a new serotonin and noradrenaline reuptake inhibitor: an overview of its antidepressant activity and clinical tolerability. Int Clin Psychopharmacol 1997; 12: 99–108.CrossRefGoogle ScholarPubMed
Revicki, DA, Brown, RE, Palmer, W, Bakish, D, Rosser, WW, Antón, SF, Feeny, D. Modelling the cost-effectiveness of antidepressant treatment in primary care. Pharmacoeconomics 1995; 8: 524–40.CrossRefGoogle ScholarPubMed
Rosholm, JU, Hallas, J, Gram, LF. Outpatient utilization of antidepressants: a prescription database analysis. J Affect Disord 1993; 27: 21–8.CrossRefGoogle ScholarPubMed
Rouillon, F, Blachier, C, Dreyfus, JP, Bouhassira, M, Allicar, MP. Étude pharmaco-épidémiologique de la consommation des antidépresseurs en population générale. L'Encéphale 1996; Suppl I: 39–48.Google Scholar
Simón, GE, Vonkorff, M, Wagner, EH, Barlow, W. Patterns of antidepressant use in community practice. Gen Hosp Psychiatry 1993; 15: 399–408.CrossRefGoogle ScholarPubMed
Souetre, E, Lozet, H, Martin, P, Lecanu, JP, Gauthier, JM, Beuzen, JN, et al. Arrét de travail et dépression. Impact de la fluoxétine. Thérapie 1993; 45: 81–8.Google Scholar
Stoudemire, A, Frank, R, Hedemark, N, Kamlet, M, Blazer, D. The economic burden of depression. Gen Hosp Psychiatry 1986; 8: 387–94.CrossRefGoogle ScholarPubMed
Thompson, C, Thompson, CM. The prescription of anti-depresants in general practice I: a critical review. Hum Psychopharmacol 1989; 4: 91–102.CrossRefGoogle Scholar
Thompson, C, Thompson, CM. Prescribing of antidepressants in general practice II: a placebo controlled trial of low dose dothiepin. Hum Psychopharmacol 1989; 4: 191–204.CrossRefGoogle Scholar
Vidal Editions du Vidal. París: Union des Caisses Nationales de Sécurité Soiciale; 1996: 1871.Google Scholar
Wells, KB, Katon, W, Rogers, B, Camp, P. Use of minor tranquillizers and antidepressant medications by depressed outpatients: results from the medical outcomes study. Am J Psychiatry 1994; 151: 694–700.Google ScholarPubMed
Weinstein, MC, Fineberg, HV. Clinical Decisión Analysis. Philadelphia: Saunders, 1992.Google Scholar
Winokur, G, Coryell, W, Endicott, J, Akiskal, H, Keller, M, Maser, JD, et al. Familial depression versus depression identified in a control group: are they the same? Psychol Med 1995; 25: 797–806.CrossRefGoogle Scholar