Study Demonstrates That Effexor Saves Costs in Treating Major Depression

Business Wire, July 13, 1998

GLASGOW, Scotland--(BW HealthWire)--July 13, 1998--

Greater efficacy results in lower utilization of healthcare services

Data presented here today shows that Effexor(R) (venlafaxine HCl) for the treatment of major depressive disorder (MDD) was more effective - and less costly - than other commonly used antidepressants. Effexor is marketed by Wyeth-Ayerst Laboratories, a division of American Home Products Corporation (NYSE: AHP).

The study, which was presented at the Collegium Internationale Neuro-Psychopharmacologium (CINP), found that Effexor resulted in annual cost savings of US $700 to $800 per patient compared with other treatment options.

"Depression is a significant clinical and economic burden to patients and societies around the world," said Steven R. Arikian, M.D., chief investigator in the study and President and CEO, the Analytica Group, New York. "This study clearly demonstrates that the superior efficacy of Effexor in the treatment of major depression can result in compelling cost savings."

One of the objectives of the study was to examine the costs associated with different treatments for depression in 11 countries (Canada, Germany, Italy, the Netherlands, Poland, Spain, Sweden, Switzerland, United Kingdom, United States, and Venezuela). The study compared 4,690 patients treated with Effexor, a serotonin-norepinephrine reuptake-inhibitor (SNRI), selective serotonin reuptake-inhibitors (SSRIs), and tricyclic antidepressants (TCAs).

When weighted by population size, the 11-country average annual direct cost of treatment of major depression with venlafaxine was estimated at US $3,751 per patient, per year, compared with US $4,457 for SSRIs and US $4,628 for TCAs.

These expenses included the cost of medications, physician services, laboratory services, and hospitalization. The study authors estimated that a 1% increase in venlafaxine use for the treatment of major depressive disorder in the countries studied would result in a savings of US$ 14.24 million in total direct costs to society and US$ 7.74 million in direct costs to payers.

A meta-analysis of the data also revealed that Effexor(R) yielded the highest overall efficacy rates (a 50% reduction in depression scores on the HAM-D or MADRS rating scales) for both outpatients (70.2%) and inpatients (62.3%).

The Cost of Depression

The World Health Organization estimates that about 10% of all patients seeking care at primary healthcare facilities worldwide suffer from depression. In 1993, the three leading types of major depressive disorder manic depression, major depression, and dysthymia - cost the United States an estimated $43.7 billion annually, similar to the cost of heart disease. In the United Kingdom, the annual cost of depression is estimated at (pound)420 million. On average, patients with major depressive disorder lose 13 work days over a six-month period, compared with 3 days for non-sufferers, and 60% to 70% of all suicides are committed by MDD sufferers.

"Choosing the most effective treatments may be able to help alleviate the staggering burden of depression," says Dr. Arikian.

Effexor and Effexor XR(R)

Effexor was developed by Wyeth-Ayerst Laboratories and received U.S. marketing clearance in 1993. Effexor XR (venlafaxine HCI) Extended-Release Capsules, a once-daily formulation of Effexor, received U.S. marketing clearance in 1997. Unlike SSRIs (e.g., Prozac), which selectively inhibit the reuptake of the neurotransmitter serotonin in the brain, Effexor and Effexor XR inhibit the reuptake of both serotonin and norepinephrine. Both medications are sold by prescription; Effexor is available in 56 countries, and Effexor XR is available in 8 countries worldwide.

Effexor(R) and Effexor XR(R) are contraindicated in patients known to be hypersensitive to venlafaxine hydrochloride and in patients taking monoamine oxidase inhibitors (MAOIs). They should not be used in combination with a MAOI or within 14 days of discontinuing treatment with a MAOI because of the potential for serious adverse reactions. Based on the half-life of venlafaxine, at least seven days should be allowed after discontinuing use of Effexor or Effexor XR before starting a MAOI.

The most commonly reported side effects in placebo-controlled trials of Effexor XR were similar to those of Effexor and included abnormal dreams, abnormal ejaculations, anorexia, dizziness, dry mouth, nausea, nervousness, somnolence, sweating, and tremor. The most common side effect, nausea, subsided to levels seen in placebo-treated patients by the second week of treatment. Venlafaxine is associated with sustained increases in blood pressure in some patients, so regular blood-pressure monitoring is recommended. In clinical trials of Effexor XR, the overall incidence of sustained increases in blood pressure was 3%. Less than 1% of patients discontinued Effexor XR due to elevated blood pressure. The incidence of sustained increases in blood pressure at doses greater than 300 mg/day has not been fully evaluated.