Depression in Managed Care: Costs of Selective Serotonin Reuptake Inhibitors

OBJECTIVE: To review data on the comparative costs of antidepressants. DESIGN: Review of data from articles identified in a Medline search, meeting presentations, and independent market research that are relevant to the costs associated with treating depression. Studies were included if they compared depression treatment costs with tricyclic antidepressants to those with one of the leading selective serotonin reuptake inhibitors (SSRIs) or if they compared treatment costs among the leading SSRIs. Data were extracted on drug acquisition costs, concomitant medications, dose titration, multitablet/multi-capsule therapy, duration of therapy, and overall treatment costs. RESULTS: SSRIs may be more costeffective than tricyclic antidepressants because they are associated with lower health care utilization. Assessment of economic outcomes with SSRI therapy can be based on identified cost drivers, including dose titration and the need for multi-tablet therapy. Among the SSRIs, the uses of nonpharmaceutical health ...