Table 4.
Monthly costs in first and second therapeutic steps from the National Institute for Health and Disability Insurance and societal perspectives
| Therapy costs | Daily dose (mg) | No. of daily intakes | Monthly costs (in €) | References | |
|---|---|---|---|---|---|
| NIHDI | Societal | ||||
| In first step | |||||
| SNRIa | |||||
| Duloxetine | 60 | 1 | 34.45 | 46.55 | NIHDI [29], Onkelinx [30] |
| Venlafaxine | 75 | 1 | 8.18 | 11.11 | |
| Mirtazapine | 30 | 1 | 11.18 | 15.05 | |
| SSRI | |||||
| Citalopram | 20 | 1 | 8.03 | 10.92 | |
| Escitalopram | 10 | 1 | 14.03 | 19.76 | |
| Fluoxetine | 20 | 1 | 4.70 | 6.35 | |
| Paroxetine | 20 | 1 | 8.50 | 11.45 | |
| Sertraline | 50 | 1 | 6.99 | 9.52 | |
| In second step | |||||
| Switch to SNRI (venlafaxine) | 75 | 1 | 8.18 | 11.11 | NIHDI [29], Onkelinx [30] |
| Switch to SSRI (sertraline) | 50 | 1 | 6.99 | 9.52 | |
| Combination with bupropion | 300 | 1 | 31.37 | 40.44 | |
| Combination with psychotherapy | NA | NA | 51.50 | 71.72 | |
| Augmentation with quetiapine | 150 | 1 | 44.90 | 47.29 | |
| Titration | |||||
| SNRIa | |||||
| Duloxetine | 60 | 2 | 68.90 | 93.10 | |
| Venlafaxine | 150 | 1 | 13.00 | 17.37 | |
| Mirtazapine | 45 | 1 | 9.71 | 13.14 | |
| SSRI | |||||
| Citalopram | 40 | 1 | 17.05 | 21.43 | |
| Escitalopram | 20 | 1 | 28.06 | 39.51 | |
| Fluoxetine | 20 | 2 | 9.39 | 12.70 | |
| Paroxetine | 30 | 1 | 10.53 | 14.18 | |
| Sertraline | 100 | 1 | 8.49 | 11.55 | |
| Switch to psychotherapy alone | NA | NA | 39.50 | 55.40 | NIHDI [29] |
| Transfer to specialist care | NA | NA | 246.70 | 309.60 | Demyttenaere et al. [12] |
NA not applicable, NIHDI National Institute for Health and Disability Insurance, SNRI serotonin–norepinephrine reuptake inhibitor, SSRI selective serotonin reuptake inhibitor
aSNRI: including mirtazapine