Based on differences in drug acquisition costs, side-effects, and risk of relapse, the model predicts that, in the Spanish healthcare setting, paliperidone ER dominates oral olanzapine and aripiprazole, with a probability of 76% and 72%, respectively.

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obtained clinical trials data for all drugs represented first line therapy for MDD. For this reason, response rates were down-adjusted to reflect their use as a second-line therapy, with each response rate being multiplied by a factor obtained from the STAR*D-trial. Since response rates were reported at a constant rate in clinical trials, they were converted into "weekly probabilities" of response. Patients entering second-line monotherapy were not differentiated by switch or add-on. QuetiapineXR(150mg) was compared with venlafaxineXR(150mg), escitalopram(10mg) and bupropionXL(300mg), which are considered to be the most relevant monotherapy comparators in Turkey. One-way sensitivity analyses were conducted on key model parameters to evaluate the robustness of the model. RESULTS:The response rates at any time over 52 weeks were 22.5% for quetiap-ineXR, venlafaxineXR 17.8%, escitalopram 12.6% and bupropionXL 10.7%. In terms of incremental cost per additional second-line responder, quetiapineXR was found to be dominant (more effective and less costly) versus venlafaxineXR (-353.55€) and quetiapineXR was cost-effective (more effective and more costly) versus escitalopram (1785.43€) and bupropionXL (652.90€). The cost per responder of quetiap-ineXR(48.85€) was less than venlafaxineXR(62.68€), escitalopram(73.20€) and bupropionXL(95.52€). CONCLUSIONS: This exploratory analysis demonstrated that in patients with MDD who have failed on previous antidepressant therapy, quetia-pineXR 150mg as monotherapy was found to be cost-effective compared to escitalopram and bupropionXL, in terms of cost per responder, and was dominant when compared to venlafaxineXR, demonstrating higher efficacy at lower costs.

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