Developing models for assessing the cost-effectiveness of antidepressants in primary care

The National Service Framework for Mental Health asks all medical professionals to use resources efficiently according to the principles of best value. Rising costs have led health service managers to encourage general practitioners to use the cheaper tricyclics in order to reduce costs. However, with antidepressants, best value is often difficult to assess. This is due to differences in price, comparability of therapeutic effect, adverse effects and suicide risk, which make it difficult to compare different preparations directly. So far, attempts to develop a model that takes into account these factors and allows clinicians to make reasoned decisions have had only limited success. This paper summarizes the factors that are important in the development of such a model.