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Comparación de la efectividad con relación al coste del milnaciprán (un SNRI) con los TCA y los SSRI: un enfoque de modelado

Published online by Cambridge University Press:  12 May 2020

R. Dardennes ,
G. Berdeaux ,
A. Lafuma  and
F. Fagnani
R. Dardennes
Affiliation:
Universidad René-Descartes París V, Hospital Santa Ana, París
G. Berdeaux
Affiliation:
Pierre Fabre Médicament SA, Boulogne-Billancourt
A. Lafuma
Affiliation:
Cemka, Bourg-la-Reine, Francia
F. Fagnani
Affiliation:
Cemka, Bourg-la-Reine, Francia
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Resumen

Se utilizó un modelo de simulación basado en la teoría del análisis de decisiones clínicas para comparar la evolución y los costes de tratar a pacientes con episodio depresivo mayor utilizando un inhibidor selectivo de la recaptación de serotonina (SSRI) o un antidepresivo tricíclico (TCA) con milnaciprán (un inhibidor de la recaptación de serotonina y norepinefrina [SNRI]). Los datos clínicos utilizados se tomaron de meta-análisis publicados. Este análisis apoya: (1) una eficacia comparable del milnaciprán y los TCA con una mejor tolerancia, y (2) una ventaja del milnaciprán sobre los SSRI en cuanto a la eficacia, con una tolerancia comparable. Sobre la base de estos resultados, se construyó un árbol de decisión con la ayuda de un equipo de psiquiatras para proporcionar un modelo de la práctica clínica usual. Se obtuvieron estimaciones no disponibles en los estudios clínicos a partir del análisis de las publicaciones o del equipo de psiquiatras. La valoración económica se realizó según el punto de vista del fondo nacional de enfermedad francés (sécurité sociale) y la evaluación del gasto se limitó a los costes directos (hospitalizaciones, medicaciones antidepresivas, visitas y pruebas de laboratorio). Los resultados indican que el milnaciprán es una posibilidad efectiva con relación a su coste: el coste esperado del tratamiento por episodio depresivo es más bajo que el de una lista representativa francesa de TCA (un ahorro de 288 francos franceses) o el de los SSRI (uno de 961 francos franceses). La duración esperada de la remisión clínica es ligeramente más alta que con los comparadores. Los análisis de la sensibilidad apoyaron la solidez de estos resultados.

Keywords

coste y consecuenciasanálisis de la decisióndepresiónfarmacoeconomíainhibidor selectivo de la recaptación de serotoninainhibidor de la recaptación de serotonina y norepinefrinaantidepresivo tricíclico
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 7 , Issue 2 , March 2000 , pp. 79 - 90
Copyright
Copyright © European Psychiatric Association 2000

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Footnotes

Dardennes R, Berdeaux G, Lafuma A, Fagnani F. Comparison of the cost-effectiveness of milnacipran (a SNRI) with TCAs and SSRIs: a modeling approach. Eur Psychiatry 1999; 14-152-62.

References

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