Cost effectiveness of SSRIs: a European perspective

The debate on the cost-effectiveness of SSRIs is taking place in the context of a general consensus on the wide prevalence of clinically significant depression. It is a chronic disease and a recent review, aimed at formulary decisions, pointed out that most patients who recover from depression will go on to experience a recurrence (Guze, 1996). The author also points out that lifetime prevalence has been estimated at a range of figures varying from 6 per cent (Reiger et al, 1988) up to figures over 20 per cent.

Recognition of the scale of the problem has been concurrent with an expansion in the range of pharmaceutical treatments<p><p>available. SSRIs constitute only one part of the growing range of treatment options. Acquisition prices of these products vary considerably: in a recent UK price guide, a typical daily dose for an adult varied from about £12 per week for the most expensive new product, down to approximately 10p for the cheapest generic TCA (MIMS, 1996) with similar variations in many other European countries. However, there are many other costs associated with treating depression. Such factors as psychiatrist interventions, outpatient clinic units and hospital admissions are far more significant in costs based attitudes to antidepressant prescribing.