Published cost-effectiveness literature shows no clear differences in total treatment costs associated with the use of different antidepressant agents, although individual studies have claimed that one particular agent is superior to another.
- In numerous studies, researchers failed to find a difference in cost or effectiveness between treatment groups.
- Several individual studies have found that treatment with newer agents is cost-saving compared to treatment with older agents
- A few other studies have found that treatment with newer agents is cost-saving compared to treatment with older agent.
- Modest evidence suggests that SSRIs are more cost-effective than TCAs.
- The evidence for the cost-effectiveness of other new-generation agents such as venlafaxine and nefazadone is less convincing, but suggests similar cost-effectiveness to SSRIs.
The clearest result from these studies is that patient compliance with the newer antidepressants is considerably better than with TCAs. For this reason, the newer antidepressants may be more cost-effective than the older antidepressants.
These studies indicate that reliance on older generation antidepressants as preferred therapy is unlikely to realize any cost-savings if total health-systems costs are to be included. As a result the exclusion of new generation antidepressants on cost grounds cannot be justified.