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Janssen's argues for the cost-effectiveness of Spravato in treatment-resistant depression

Published on 23/05/19 at 10:45am

Janssen has unveiled a new cost-effectiveness analysis for its recently FDA-approved nasal spray Spravato (esketamine) in the treatment of treatment-resistant depression (TRD) at the International Society for Pharmacoeconomics and Outcomes Research Annual Meeting (ISPOR 2019).

The company argued that Spravato, in combination with an oral antidepressant, is a cost-effective alternative to the combination of an oral antidepressant and placebo in the treatment of TRD, defined as those patients who have not responded to two or more oral antidepressants within the same depressive episode.

Estimates have placed the societal cost of TRD at $29 billion to $48 billion in the US, in part due to reduced productivity and increased suicide risk, and this is without including the costs associated with major depressive disorder (MDD).

Janssen’s analysis of the costs of achieving and maintaining TRD remission utilised a cost-per-remitter model in line with recommendations from the Agency of Healthcare Research and Quality (AHRQ). With Spravato plus an oral antidepressant, this cost was determined to be at least $20,000 less per patient than with an oral antidpressant plus placebo, based on response, remission and relape rates from Phase 3 clinical trials, and these costs tripled when lost productivity was taken into account. These savings were similar across a range of US payers, including Medicaid, the US Department of Veterans Affairs (VA), and Integrated Delivery Networks (IDN).

“Given the profound emotional, functional, and economic burden of treatment-resistant depression, it was extremely important to comprehensively assess the economic value newly-approved Spravato can bring to patients, payers, and society,” commented Dr John Sheehan, Director of Real-World Value and Evidence at Janssen and co-author of the economic analysis. “We found that, because it can help more patients have a significant reduction in their depressive symptoms compared to an oral antidepressant plus placebo, Spravato is a meaningful clinical and economic investment. People who no longer experience ongoing depressive symptoms pay less to manage their disease, reduce the cost to the overall healthcare system, and are able to get back to their lives.”

Matt Fellows

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