Brand-name, generic antidepressants share similar discontinuation rates and healthcare costs during 6 months of treatment

Key Points

Patients using brand-name or generic antidepressant medications to treat major depressive disorder have similar drug discontinuation rates and accrue comparable healthcare costs during the first 6 months of treatment, according to a study published in March 2011 in the Journal of Managed Care Pharmacy.

While describing the impetus for their study, study researchers noted that various case reports and bioequivalence studies have attempted to make the case that generic antidepressants have poorer efficacy and tolerability compared with their brand-name equivalents.

"The study's results do not support the contention sometimes made by critics of pharmacy utilization management tools that generic antidepressants are less effective or safe than brand drugs," the researchers stressed.

Their analysis showed that users of brand-name or generic antidepressant medications did not differ in their adjusted odds of drug discontinuation (OR=1.09; 95% CI, 0.98–1.22). Moreover, adjusted average 6-month SSRI/SNRI antidepressant costs were 43.7% lower in patients initiated on a generic drug ($174; 95% CI, $169–$180 vs $309; 95% CI, $300–$319). Adjusted, average all-cause 6-month healthcare costs were found to be statistically similar as well ($3,660; 95% CI, $3,538–$3,787 for patients initiating therapy on a generic antidepressant vs $4,587; 95% CI, $4,422–$4,757 for patients initiating therapy on a brand-name antidepressant).

The researchers emphasized, "The initiation of antidepressant therapy with a generic SSRI or SNRI could reduce the pharmacy costs for healthcare payers by almost 50% in some cases, without leading to treatment failure or increased medical costs in the short term."

Depression is a major cause of disability in the United Sates and accounts for more than $83 billion in direct and indirect (lost productivity) costs annually. In 2009, 3 of the top 12 prescription medications (by number of prescriptions) were antidepressants.

SOURCES

Vlahiotis A, Devine ST, Eichholz J, Kautzner A. Discontinuation rates and health care costs in adult patients starting generic versus brand SSRI or SNRI antidepressants in commercial health plans. J Manag Care Pharm. 2011;17(2):123–132.

Greenberg PE, Kessler RC, Birnbaum HG, Leong SA. The economic burden of depression in the United States: how did it change between 1990 and 2000? J Clin Psychiatry. 2003;64(12):1465–1475.

2009 Top 200 branded drugs by total prescriptions. SDI/Verispan, VONA. Available at: http://drugtopics.modernmedicine.com/drugtopics/data/articlestandard//drugtopics/252010/674969/article.pdf. Accessed March 1, 2011.