SSRI cost drivers in managed care

PharmacoEconomics & Outcomes News 314 - 26 May 2001

SSRI cost drivers in managed careSelective serotonin reuptake inhibitor (SSRI) dosage

titration and the need for multi-tablet therapies areimportant cost drivers in the treatment of depression inthe managed-care setting, says Dr Bentson McFarland atOregon Health Sciences University, Portland, US.*

Titration can affect the cost effectiveness of SSRIsbecause of costs associated with dosage adjustments,he says. Higher dosages are associated with higher drugcosts and increased healthcare provider time,particularly if multiple tablets are required. Titration toachieve therapeutic dosages may result in additional useof medical services while the patient awaits an effectiveresponse, or may lead to premature discontinuation oftherapy.

Other factors affecting the economic outcome of SSRItreatment in the managed-care environment identifiedby Dr McFarland include:• pill splitting, which may drive up total healthcare

costs by increasing patient noncompliance• the costs of concomitant psychotropic drugs, which

may be comparable for all SSRIs• SSRI acquisition costs, which are lowest for

citalopram and highest for sertraline• the duration of SSRI treatment, which is often

shorter than guideline recommendations forantidepressant maintenance therapy

• additional healthcare resource use, e.g. tricyclicantidepressants are less expensive than SSRIs butmay incur higher total healthcare costs because ofadditional healthcare resource use.

* Dr McFarland’s comments are based on the findings of a literaturereview funded by GlaxoSmithKline.

McFarland BH. Depression in managed care: costs of selective serotonin reuptakeinhibitors. Journal of Managed Care Pharmacy 7: 142-148, Mar-Apr2001 800852609

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PharmacoEconomics & Outcomes News 26 May 2001 No. 3141173-5503/10/0314-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved