Budget Impact Analysis nel trattamento della depressione maggiore nelle diverse regioni Italiane: il ruolo di Venlafaxina

Autori: Giorgio L. Colombo, Sergio Di Matteo

Venlafaxine (Efexor – Wyeth) is a serotonin-norepinephrine reuptake inhibitor (SNRI) approved for the treatment of major depressive disorder (MDD). Following patent expiration, venlafaxine is available as generic at a reduced price.

To evaluate the overall savings to the National Health System (NHS) following venlafaxine’s price reduction, a Budget Impact Analysis was carried out. Additional potential savings were assessed in two hypothetical scenarios supposing an increase in the market share of venlafaxine by substitution of different proportions of other branded products such as duloxetine and escitalopram.

Mean annual treatment cost with venlafaxine decreased from €567 to €284 resulting in overall savings to the NHS of more than €44 million per year. Treatment switching from escitalopram and/or duloxetine to venlafaxine was always a dominant strategy and resulted in a higher number of patients treated more efficaciously since venlafaxine performs better in terms of remission and is less expensive. Sensitivity analyses on effectiveness (response) and cost variables confirmed our results.

This analysis suggests that extended use of generic venlafaxine is likely to lead to overall cost savings to the NHS due to its cost-effectiveness profile compared with other antidepressants as duloxetine and escitalopram.

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