Table 1.

List and description of Markov health states

Health state number	Health state descriptor	Patient description
1 (initial)	Family physician assessment (initial health state)	Family practice physician initially diagnoses and treats GAD with 1st line agents May re-enter model after at least one cycle in treatment discontinuation state
2	Specialist assessment 2nd line	Treatment managed by a psychiatrist prescribing 2nd line treatment options (i.e., patient Intolerant to 1st line agents, or responded to 1st line medication but not remitted, or neither responded nor remitted to 1st line therapy)
3	Specialist assessment 3rd line	Treatment managed by a psychiatrist prescribing 3rd line or treatment-resistant options (i.e., intolerant or did not respond to 1st or 2nd line pharmacotherapy)
4–7	Maintenance therapies	Patients on maintenance therapy who have achieved remission in 1st line or 2nd line health states Patients who have achieved remission or response and are maintained with 3rd line therapy
8	Treatment discontinued	Patients discontinue therapy for any reason
9	Absorbing state	Death—patients removed from model

GAD generalized anxiety disorder