A recent study highlights the economic benefits of introducing brexpiprazole early in the treatment regimen for patients with major depressive disorder (MDD) who do not respond adequately to standard SSRI or SNRI medications. This approach not only enhances patient outcomes but also offers a cost-effective strategy within the Japanese healthcare system.
Study Purpose and Methods
Researchers conducted a cost-utility analysis from the perspective of the Japanese public healthcare payer. The study compared the addition of brexpiprazole to placebo (no add-on) alongside SSRI/SNRI treatments in MDD patients with insufficient responses. Additionally, the analysis evaluated the financial and quality-adjusted life-year (QALY) gains of initiating brexpiprazole after 8 weeks (early add-on) versus 14 weeks (late add-on) of standard treatment. The study modeled patient cohorts over a 67-week horizon based on clinical trial data.
Economic Implications
The findings revealed that initiating brexpiprazole early is cost-effective, aligning with the willingness to pay threshold of 5 million JPY per QALY. Specifically, early add-on treatment resulted in a gain of 0.037 QALYs at an additional cost of JPY 155,762, yielding an incremental cost-effectiveness ratio (ICER) of JPY 4.3 million per QALY compared to no add-on. When compared to late add-on, the early approach provided a smaller yet significant QALY gain of 0.008 at a total cost increase of JPY 3,663, translating to an ICER of JPY 0.46 million per QALY.
- Early intervention with brexpiprazole can lead to better patient adherence and faster symptom relief.
- Healthcare systems may reduce long-term costs by preventing chronic depression through timely treatment adjustments.
- Economic benefits are contingent on the accurate prediction of patient response to adjunct therapy.
The study acknowledges limitations, including the restriction of the modeling horizon to the trial duration, which may not capture long-term benefits. Additionally, uncertainties exist regarding incremental QALY gains when comparing early to late add-on strategies.
Healthcare policymakers and practitioners can leverage these insights to refine treatment protocols for MDD. By adopting an early add-on strategy with brexpiprazole, both clinical outcomes and economic efficiency can be optimized, potentially transforming the management of depression within public health frameworks.
Integrating brexpiprazole early in treatment plans offers a dual advantage of enhancing patient quality of life while maintaining economic sustainability. Decision-makers should consider these findings to improve mental health services and allocate resources effectively, ensuring that patients receive timely and cost-effective care.
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