A Systematic Review of Model-Based Economic Evaluations of Drug Substitution Therapies in Maintenance Treatment of Non-Prescription Opioid Dependence

Abstract

A411costs and productivity losses were calculated. Costs data were derived from Russian cost-of-illness study of depression and registered maximal drug prices list. The outcomes were modelled for 3 years period. Costs were converted to EUROs using the average weighted exchange rate in 2014 (1€ = 50.815RUR). Sensitivity analysis was performed. Results: Agomelatine appeared to be the dominant therapy in comparison with branded fluoxetine, sertraline and escitalopram, which allowed achieving maximum clinical outcome and utility (2.148 QALY vs 2.097, 2.133 and 2.119 QALY, respectively) at the lowest costs (€ 1,932 vs € 2,485, € 2,076 and € 2,454). Agomelatine remained dominant strategy even when only direct medical costs were included into analysis (€ 943 vs € 1,172, € 1,002 and € 1,290). ConClusions: Agomelatine was demonstrated to be the rational choice in comparison with other branded antidepressants routinely used in Russian health care settings.