, Volume 5, Issue 3, pp 249–264 | Cite as

Cost Utility of Maintenance Treatment of Recurrent Depression with Sertraline Versus Episodic Treatment with Dothiepin

  • Evridiki J. Hatziandreu
  • Ruth E. Brown
  • Dennis A. Revicki
  • Ralph Turner
  • Jacqueline Martindale
  • Sydney Levine
  • Joanna E. Siegel


The objective of this study was to model, for patients at risk of recurrent depression, the cost-utility of maintenance therapy with sertraline compared with treatment of acute episodes with dothiepin (‘episodic treatment’). Using clinical decision analysis techniques, a Markov state-transition model was constructed to estimate the lifetime costs and quality-adjusted life-years (QALYs) of the 2 therapeutic strategies. The model follows 2 cohorts of 35-year-old women at high risk for recurrent depression over their lifetimes. Model construction and relevant data (probabilities) for performing the analysis were based on existing clinical knowledge. Two physician panels were used to obtain estimates of recurrence probabilities not available in the literature, health utilities, and resource consumption. Costs were obtained from published sources. The baseline analysis showed that it costs £2172 ($US3692, 1991 currency) to save an additional QALY with sertraline maintenance treatment. Sensitivity analysis showed that the incremental cost-utility ratio ranged from £557 to £5260 per QALY. Overall, the resulting ratios are considered to be well within the range of cost-utility ratios that support the adoption and appropriate utilisation of a technology. Based on the study assumptions, long term maintenance treatment with sertraline appears to be clinically and economically justified choice for patients at high risk of recurrent depression.


Major Depression Discount Rate Maintenance Therapy Sertraline Depressive Episode 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Adis International Limited 1994

Authors and Affiliations

  • Evridiki J. Hatziandreu
    • 1
    • 6
  • Ruth E. Brown
    • 1
    • 6
  • Dennis A. Revicki
    • 1
    • 6
  • Ralph Turner
    • 2
  • Jacqueline Martindale
    • 3
  • Sydney Levine
    • 4
  • Joanna E. Siegel
    • 5
  1. 1.Battelle Medical Technology Assessment and Policy (MEDTAP) Research CentersWashington, DCUSA
  2. 2.Pfizer Central ResearchGrotonUSA
  3. 3.Pfizer International, Pharmaceuticals GroupNew YorkUSA
  4. 4.Royal Oldham HospitalManchesterEngland
  5. 5.Harvard School of Public HealthBostonUSA
  6. 6.Battelle Medical Technology Assessment and Policy (MEDTAP) Research CentersLondonEngland

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