{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T14:58:52Z","timestamp":1776869932217,"version":"3.51.2"},"reference-count":45,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,5,10]],"date-time":"2019-05-10T00:00:00Z","timestamp":1557446400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychiatry Clin Neurosci"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Previous studies indicate that mirtazapine is unique in its quick responsiveness compared to other antidepressants. Although some other studies have evaluated its cost\u2010effectiveness, they have not considered its early stage remission rate. The aim of this study was to address this research gap by using precise clinical data to evaluate the cost\u2010effectiveness of mirtazapine in Japan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We developed a Markov model to reflect the week\u2010by\u2010week transition probabilities. The Markov cycle was set as 1\u2009week. While our clinical parameters were obtained largely from existing meta\u2010analyses, cost data were derived from government reports. Cost\u2010effectiveness was evaluated by incremental cost\u2010effectiveness ratios (ICERs) per quality\u2010adjusted life year estimated based on the probability sensitivity analyses. The ICERs were estimated at 2, 8, 26, and 52\u2009weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In severe depression, the ICERs ranged between JPY 872\u2009153 and 1\u2009772\u2009723. The probability of mirtazapine being cost\u2010effective ranged from 0.75 to 0.99 when the ICER threshold was JPY 5\u2009000\u2009000. In moderate depression, the ICERs ranged between JPY 2\u2009356\u2009499 and 4\u2009770\u2009145. The probability of mirtazapine being cost\u2010effective ranged from 0.55 to 0.83 when the ICER threshold was JPY 5\u2009000\u2009000.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>When considering the early stage efficacy of mirtazapine, it appeared to be cost\u2010effective compared to selective serotonin reuptake inhibitors, especially for severe depression and in the early stage treatment in the Japanese setting. However, our study has some limitations. First, mirtazapine is compared with batched selective serotonin reuptake inhibitors rather than individual ones. Second, we did not consider antidepressant combination therapy as treatment options.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pcn.12851","type":"journal-article","created":{"date-parts":[[2019,4,12]],"date-time":"2019-04-12T01:55:40Z","timestamp":1555034140000},"page":"400-408","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Does the rapid response of an antidepressant contribute to better cost\u2010effectiveness? 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