Barbui Corrado, Percudani Mauro, Hotopf Matthew
Department of Medicine and Public Health, Section of Psychiatry, University of Verona, Italy.
J Clin Psychopharmacol. 2003 Apr;23(2):145-54. doi: 10.1097/00004714-200304000-00007.
The purpose of this study was to examine whether experimental and observational pharmacoeconomic analyses of antidepressant drugs support the choice of one of the selective serotonin reuptake inhibitors or newer antidepressants as first-line treatment for patients with major depression. We systematically reviewed economic evaluations of two or more antidepressants completed in clinical practice. A systematic electronic search yielded 38 studies meeting the inclusion criteria, of which 23 were administrative database analyses, 12 were observational studies, and 3 were randomized clinical trials. Experimental data indicated that tricyclic antidepressants are equivalent to selective serotonin reuptake inhibitors in terms of total expenditure. While the database analyses are susceptible to bias and confounding variables, they provided an added dimension based on observations from everyday clinical practice. The majority of these studies failed to show any significant difference. Taken together, available pharmacoeconomic studies indicate that tricyclic drugs and selective serotonin reuptake inhibitors have similar cost effectiveness in the health care systems where these comparisons have been made.
本研究的目的是检验抗抑郁药物的实验性和观察性药物经济学分析是否支持选择选择性5-羟色胺再摄取抑制剂或新型抗抑郁药物之一作为重度抑郁症患者的一线治疗药物。我们系统回顾了在临床实践中完成的两种或更多抗抑郁药物的经济学评价。系统的电子检索产生了38项符合纳入标准的研究，其中23项是行政数据库分析，12项是观察性研究，3项是随机临床试验。实验数据表明，就总费用而言，三环类抗抑郁药物与选择性5-羟色胺再摄取抑制剂相当。虽然数据库分析容易受到偏倚和混杂变量的影响，但它们基于日常临床实践的观察提供了一个额外的维度。这些研究中的大多数未能显示出任何显著差异。综合来看，现有的药物经济学研究表明，在已进行这些比较的卫生保健系统中，三环类药物和选择性5-羟色胺再摄取抑制剂具有相似的成本效益。
