The University of Southampton
University of Southampton Institutional Repository

Constraints on antidepressant prescribing and principles of cost-effective antidepressant use. Part 1

Constraints on antidepressant prescribing and principles of cost-effective antidepressant use. Part 1
Constraints on antidepressant prescribing and principles of cost-effective antidepressant use. Part 1
Depression is a common, recurrent, disabling and potentially fatal disorder. Its effect on quality of life is more severe than that of some other chronic medical conditions. Its cost burden (direct and indirect) has been estimated at $US26 billion to $US43.7 billion in the US (in 1990), and 3.4 billion pounds sterling in the UK (in 1992).

With contemporary levels of diagnosis and treatment, and of treatment failure, the indirect economic losses to society from depression-associated morbidity and mortality may be up to 7 times the direct costs, with 69 to 98% of these costs related to morbidity. Impaired capacity while at work may equal absenteeism in terms of costs. Depression carries an increased risk of suicide and suicide attempts, both of which are costly. It is ironic, then, that the drugs used to treat depression account for 9% of poisoning deaths in England and Wales. The newer antidepressants are less toxic than the tricyclic antidepressants (TCAs).

The physician’s choice of antidepressant should be motivated primarily by clinical considerations, but cost implications are of increasing importance. In some healthcare systems, the expenditure associated with prescribing by doctors has been successfully modified, at least temporarily, by drug formularies, audit and feedback. This may be to the disadvantage of the selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors; they have higher acquisition costs than the TCAs, since they are newer and lack cheaper generic forms, and definitive evidence of benefits may be inadequate or equivocal. However, market price is only one of many factors that should affect the prescriber, and the increasing trend towards cost containment policies is liable to lead to false economies
1170-7690
419-443
Henry, John A.
721c53d6-13d0-4fd5-aa84-7367cde9ca72
Rivas, Carol A.
040bfbc1-0aef-4826-ab58-e85743fea9d4
Henry, John A.
721c53d6-13d0-4fd5-aa84-7367cde9ca72
Rivas, Carol A.
040bfbc1-0aef-4826-ab58-e85743fea9d4

Henry, John A. and Rivas, Carol A. (1997) Constraints on antidepressant prescribing and principles of cost-effective antidepressant use. Part 1. PharmacoEconomics, 11 (5), 419-443. (doi:10.2165/00019053-199711050-00005).

Record type: Article

Abstract

Depression is a common, recurrent, disabling and potentially fatal disorder. Its effect on quality of life is more severe than that of some other chronic medical conditions. Its cost burden (direct and indirect) has been estimated at $US26 billion to $US43.7 billion in the US (in 1990), and 3.4 billion pounds sterling in the UK (in 1992).

With contemporary levels of diagnosis and treatment, and of treatment failure, the indirect economic losses to society from depression-associated morbidity and mortality may be up to 7 times the direct costs, with 69 to 98% of these costs related to morbidity. Impaired capacity while at work may equal absenteeism in terms of costs. Depression carries an increased risk of suicide and suicide attempts, both of which are costly. It is ironic, then, that the drugs used to treat depression account for 9% of poisoning deaths in England and Wales. The newer antidepressants are less toxic than the tricyclic antidepressants (TCAs).

The physician’s choice of antidepressant should be motivated primarily by clinical considerations, but cost implications are of increasing importance. In some healthcare systems, the expenditure associated with prescribing by doctors has been successfully modified, at least temporarily, by drug formularies, audit and feedback. This may be to the disadvantage of the selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors; they have higher acquisition costs than the TCAs, since they are newer and lack cheaper generic forms, and definitive evidence of benefits may be inadequate or equivocal. However, market price is only one of many factors that should affect the prescriber, and the increasing trend towards cost containment policies is liable to lead to false economies

This record has no associated files available for download.

More information

Published date: May 1997
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 378026
URI: http://eprints.soton.ac.uk/id/eprint/378026
ISSN: 1170-7690
PURE UUID: 7eabc9ec-49ea-43f0-befd-a8c9e787669d

Catalogue record

Date deposited: 15 Jun 2015 09:32
Last modified: 14 Mar 2024 20:14

Export record

Altmetrics

Contributors

Author: John A. Henry
Author: Carol A. Rivas

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×