Cost-effectiveness of vortioxetine compared with levomilnacipran and vilazodone in patients with major depressive disorder switching from an initial antidepressant. (2nd January 2021)

• Record Type: Journal Article
• Authors: Atsou, Kokuvi; Ereshefsky, Larry; Brignone, Mélanie; Danchenko, Natalya; Diamand, Françoise; Mucha, Lisa; Touya, Maëlys; Becker, Russell; François, Clément
• Is Part Of: Expert review of pharmacoeconomics & outcomes research. Volume 21:Number 1(2021)
• Page Start: 29
• Page End: 42
• Publication Date: 2021-01-02
• Subjects: Antidepressants -- incremental cost-effectiveness -- levomilnacipran -- major depressive disorder -- quality-adjusted life-year -- vilazodone -- vortioxetine; Pharmacology -- Economic aspects -- Periodicals; 338.47615105
• DOI: 10.1080/14737167.2021.1855979
• Languages: English
• ISSNs: 1473-7167

Abstract

ABSTRACT: Introduction: Many patients with major depressive disorder (MDD) do not achieve remission with their first antidepressant (AD), resulting in a high burden due to treatment failure. Vortioxetine is a valid treatment option for patients with MDD only partially responding to their first AD. Characterization of vortioxetine's potential benefits versus other approved treatments is important. Areas covered: The cost-effectiveness of vortioxetine, including cognitive outcomes, was modeled in comparison with levomilnacipran and vilazodone for patients switched to these medications after inadequate responses to a first AD. Expert opinion: Vortioxetine was associated with incremental quality-adjusted life-year (QALY) gains versus levomilnacipran (0.008) or vilazodone (0.009). Vortioxetine was dominant versus levomilnacipran and cost-effective versus vilazodone (incremental cost-effectiveness ratio [ICER], 33, 829 USD/QALY). In sensitivity analyses using residual cognitive dysfunction rates (vortioxetine, 49%; levomilnacipran, 58%, and vilazodone, 64%), incremental QALY gains for vortioxetine versus levomilnacipran (0.0085) or vilazodone (0.0109) were found. Vortioxetine remained dominant versus levomilnacipran and cost-effective versus vilazodone (ICER, 27, 633 USD/QALY). ICER reduction was found with cognition outcomes inclusion. This model provides additional support for considering vortioxetine for patients requiring a switch of MDD treatments, although its conclusions are limited by the data available for inclusion. Additional research and real-world trials are needed to confirm the findings.