Beijing An Ding Hospital, Capital Medical University, China National Clinical Research Center for Mental Disorders, Beijing, China.
Division of Health Technology Assessment and Policy Evaluation, China National Health Development Research Center (CHNHDR), National Health Commission, Beijing, China.
Curr Med Res Opin. 2020 May;36(5):875-882. doi: 10.1080/03007995.2020.1723072. Epub 2020 Feb 13.
To compare the rates of successfully treated patients (STPs) with vortioxetine versus venlafaxine in major depressive disorder (MDD), using dual endpoints that combine improvement of mood symptoms with optimal tolerability or functional remission, and conduct a simplified cost-effectiveness analysis. The 8-week SOLUTION study (NCT01571453) assessed the efficacy and safety of vortioxetine (10 mg/day) versus venlafaxine XR (150 mg/day) in adult Asian patients with MDD. Rates were calculated post-hoc of STP Mood and Tolerability (≥50% reduction from baseline in Montgomery-Åsberg Depression Rating Scale [MADRS] total score and no treatment-emergent adverse events) and STP Mood and Functioning (≥50% reduction from baseline in MADRS total score and Sheehan Disability Scale total score ≤6). The incremental costs per STP were assessed using the 2018 pharmacy purchase prices for branded vortioxetine/branded venlafaxine in China as the base case. STP Mood and Tolerability rates were 28.9% for vortioxetine and 19.9% for venlafaxine ( = .028); the corresponding STP Mood and Functioning rates were 28.0% and 23.5% ( = .281). Drug costs for the 8-week treatment period were CN¥1954 for vortioxetine and CN¥700 for venlafaxine. The incremental cost per STP for vortioxetine versus venlafaxine was CN¥13,938 for Mood and Tolerability and CN¥27,876 for Mood and Functioning. Higher rates of dual treatment success were seen with vortioxetine versus venlafaxine. Although vortioxetine was not dominant in the base case, the incremental cost per STP for vortioxetine versus venlafaxine were overall within acceptable ranges. These results support the benefits previously reported with vortioxetine versus other antidepressants in broad efficacy, tolerability profile and cost-effectiveness.
比较度洛西汀与文拉法辛治疗重度抑郁症（MDD）患者的有效率（STP），采用双重终点，即改善情绪症状与最佳耐受性或功能缓解相结合，并进行简化的成本效益分析。8 周的 SOLUTION 研究（NCT01571453）评估了度洛西汀（10mg/天）与文拉法辛 XR（150mg/天）在成年亚洲 MDD 患者中的疗效和安全性。采用事后分析法计算 STP 情绪和耐受性（MADRS 总分较基线降低≥50%，且无治疗引起的不良事件）和 STP 情绪和功能（MADRS 总分较基线降低≥50%，且 Sheehan 残疾量表总分≤6）的有效率。采用 2018 年中国度洛西汀/文拉法辛品牌药的购药价格作为基数案例，评估每个 STP 的增量成本。度洛西汀的 STP 情绪和耐受性有效率为 28.9%，文拉法辛为 19.9%（ = .028）；相应的 STP 情绪和功能有效率分别为 28.0%和 23.5%（ = .281）。8 周治疗期的药物成本分别为度洛西汀 1954 元人民币和文拉法辛 700 元人民币。度洛西汀与文拉法辛相比，每个 STP 的增量成本分别为 Mood and Tolerability 13938 元人民币和 Mood and Functioning 27876 元人民币。度洛西汀组的双重治疗成功率高于文拉法辛组。尽管度洛西汀在基数案例中并不占优势，但度洛西汀与文拉法辛相比，每个 STP 的增量成本总体上仍在可接受范围内。这些结果支持了与其他抗抑郁药相比，度洛西汀在广泛疗效、耐受性和成本效益方面的优势。
