There is currently no published guideline on the management of major depressive disorder (MDD) in Belgium.

The most recent assessment of the cost effectiveness of antidepressants in Belgium was published in 2005.

Our study updates the cost-effectiveness assessment of first-line pharmaceutical treatment of MDD in Belgium, reflecting current clinical practice and considering all relevant comparators.

Our model was based on the TLV (Tandvårds- och läkemedelsförmånsverket) model developed with the aim to reassess antidepressants in Sweden following the implementation of new reimbursement rules.

In the base-case analysis, escitalopram dominated all the comparators except venlafaxine from the national health insurance (National Institute for Health and Disability Insurance; NIHDI) perspective, and all the comparators from the societal perspective.

Escitalopram was associated with the highest probability of being the optimal treatment from the NIHDI and societal perspectives.