Cost-per-remitter for esketamine nasal spray versus quetiapine for treatment-resistant depression
Aim: Estimate the cost-per-remitter with esketamine nasal spray plus an oral antidepressant (ESK NS + OAD) versus quetiapine extended release plus an oral antidepressant (QTP XR + OAD) among adults with treatment-resistant depression (TRD). Materials & methods: An Excel-based model was develop...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Becaris Publishing Limited
2025-06-01
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| Series: | Journal of Comparative Effectiveness Research |
| Subjects: | |
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| Summary: | Aim: Estimate the cost-per-remitter with esketamine nasal spray plus an oral antidepressant (ESK
NS + OAD) versus quetiapine extended release plus an oral antidepressant (QTP XR + OAD) among adults
with treatment-resistant depression (TRD). Materials & methods: An Excel-based model was developed
to estimate the cost-per-remitter for ESK NS + OAD and QTP XR + OAD from the perspective of a
US commercial insurance plan and Medicaid. Remission and response rates were estimated in 4-week
intervals over 32 weeks using data from the ESCAPE-TRD phase IIIb clinical trial comparing ESK NS + OAD
versus QTP XR + OAD in adults with TRD. Direct healthcare costs were sourced from health economic
literature and the RED BOOK R drug pricing database. Indirect costs were derived from a separate analysis
of ESCAPE-TRD using the Work Productivity and Activity Impairment: Depression questionnaire. Adults
not remitting/responding either stayed on current treatment or discontinued current treatment and
initiated either augmented therapy with antipsychotics or repetitive transcranial magnetic stimulation.
In a scenario analysis, all individuals who did not achieve response and discontinued treatment initiated
repetitive transcranial magnetic stimulation. Results: The remission rate at 32 weeks was 50% for adults
receiving ESK NS + OAD and 33% for adults receiving QTP XR + OAD. The cost-per-remitter for ESK
NS + OAD compared with QTP XR + OAD was $3102.17 lower in the commercial setting and $456.12 lower
in the Medicaid setting. Under the scenario analysis, the cost-per-remitter for ESK NS + OAD compared
with QTP XR + OAD was $15,133.66 lower in the commercial setting and $12,487.62 lower in theMedicaid
setting. Conclusion: The findings suggest that ESK NS + OAD is a cost-effective treatment for adults with
TRD compared with QTP XR + OAD in the commercial and Medicaid settings. |
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| ISSN: | 2042-6313 |