PMH32 Cost-Effectiveness of Agomelatine in the Treatment of Major Depressive Episodes in Thailand

Abstract

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.