Pharmacoeconomic evaluation of venlafaxine compared with citalopram in generalized anxiety disorder

Abstract

Pharmacoeconomic evaluation aims to investigate the selection and use of drugs to make patient medication efficient, safe and economical. In this study, a pharmacoeconomic evaluation was performed to assess two treatments for generalized anxiety disorder (GAD). A total of 100 outpatients with GAD were enrolled. The patients were divided into the following two groups according to treatment program: the venlafaxine group (n=50) and the citalopram group (n=50). The patients in the venlafaxine group received 75 mg of orally administered venlafaxine and 50 mg of sulpiride once a day for the first seven days and thereafter only 150 mg of venlafaxine once a day. The patients in the citalopram group received 10 mg of citalopram and 50 mg of sulpiride orally once a day for the first seven days and thereafter only 20 mg once a day. The treatment period for the two groups was three months. Follow-up was conducted at the end of weeks 2, 4 and 12 to evaluate drug efficacy, quality of life and drug side-effects. Moreover, the two groups were scored according to cost-effectiveness analysis. Using the SF-36 Scale, the quality of life score of the patients in the venlafaxine group was observed to be significantly higher compared with that of the patients in the citalopram group at the end of weeks 4 and 12 (P<0.05). The reduction rates of the Hamilton Anxiety (HAMA) scale show that the efficacy of venlafaxine was significantly better than that of citalopram by the end of week 12. The findings of this study suggest that venlafaxine is more cost-effective than citalopram in the treatment of outpatients with GAD. Introduction Anxiety disorder is one of the most common mental disorders handled in general hospitals. Anxiety disorder was recently reported to have prevalence of 5.6% (5.0-6.3%) in several regions of China (1). Generalized anxiety disorder (GAD) is a disabling disease often diagnosed with other mental disorders, and thus causes a heavy burden on patients (2). In current clinical practice, the major therapeutic drugs for GAD include selective serotonin reuptake inhibitors (SSRI) and serotonin and norepinephrine reuptake inhibitors (SNRI). GAD requires long-term treatment of at least 12 months in the first instance (3-5). Given the prolonged duration of the treatment, clinical practitioners should consider cost-effectiveness when selecting therapeutic plans. Citalopram and venlafaxine, which are reasonably priced drugs covered by Medicare, are two well-accepted drugs for GAD treatment. Doctors and patients alike are willing to use citalopram and venlafaxine, making these drugs comparable for study. In the present study, a quality of life scale was employed to thoroughly evaluate and examine the efficacy of the two treatments (6).