A cost-effectiveness analysis of escitalopram as first line treatment of depression in Sweden

This paper is an economic evaluation from a Swedish healthcare perspective of escitalopram, a new selective serotonin re-uptake inhibitor, compared with venlafaxine and generic citalopram in the treatment of major depressive disorder [baseline scores >= 8 and <= 40 on the Montgomery-Asberg Depression Rating Scale]. The analysis is based on a decision model with a six-month time horizon in which treatment begins in primary care after which the patient is referred for further specialist care if necessary. The results indicate that escitalopram provides a cost-effective alternative in the pharmacological treatment of major depressive disorder: escitalopram gives better expected results of treatment and lower expected treatment costs than generic citalopram and venlafaxine. These results are consistent with those of a comparative double-blind randomised clinical study and other economic evaluations of escitalopram compared with venlafaxine.