{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:43:11Z","timestamp":1777419791626,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2012,5,1]],"date-time":"2012-05-01T00:00:00Z","timestamp":1335830400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2012,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>While the clinical utility of atypical antipsychotics has been established in patients with major depressive disorder (MDD) who are refractory to antidepressant therapy, their cost-effectiveness is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To examine the cost-effectiveness of aripiprazole, quetiapine, and olanzapine\/fluoxetine in adults with MDD who are refractory to antidepressant therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Using techniques of decision analysis, we estimated expected outcomes and costs over 6 weeks in adults with MDD receiving (1) aripiprazole 2-20 mg\/day and antidepressant therapy; (2) quetiapine 150 mg\/day or 300 mg\/day and antidepressant therapy; (3) the fixed-dose combination of olanzapine 6, 12, or 18 mg\/day with fluoxetine 50 mg\/day; or (4) antidepressant therapy alone. Cost-effectiveness was assessed in terms of the cost per additional responder at 6 weeks, defined as the ratio of the difference in the cost of MDD-related care over 6 weeks versus antidepressant therapy afone to the difference in the number of patients achieving clinical response by 6 weeks. We estimated the model using data from Phase 3 clinical trials of atypical antipsychotics along with other secondary data sources.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>With antidepressant therapy alone, the estimated clinical response rate at 6 weeks was 30%. Aripiprazole, quetiapine 150 mg\/day, quetiapine 300 mg\/day, and olanzapine\/fluoxetine were estimated to increase clinical response at 6 weeks to 49%, 34%, 38%, and 45%. respectively. Costs of MDD-related care over 6 weeks were estimated to be $192 for antidepressant therapy, $847 for aripiprazole, $541 for quetiapine 150 mg\/day, $672 for quetiapine 300 mg\/day plus antidepressant therapy, and $791 for olanzapine\/fluoxetine. Costs per additional responder (vs antidepressant therapy) over a 6-week period were estimated to be $3447 for aripiprazole, $8725 for quetiapine 150 mg\/day, $6000 for quetiapine 300 mg\/day, and $3993 for olanzapine\/fluoxetine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Atypical antipsychotics substantially increase clinical response at 6 weeks. Cost per additional responder is lower for aripiprazole than for quetiapine or olanzapine\/fluoxetine.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.1q326","type":"journal-article","created":{"date-parts":[[2012,5,2]],"date-time":"2012-05-02T00:11:57Z","timestamp":1335917517000},"page":"642-649","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Cost-Effectiveness of Adjunctive Therapy with Atypical Antipsychotics for Acute Treatment of Major Depressive Disorder"],"prefix":"10.1177","volume":"46","author":[{"given":"Charu","family":"Taneja","sequence":"first","affiliation":[{"name":"Policy Analysis Inc., Brookline, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George I","family":"Papakostas","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yonghua","family":"Jing","sequence":"additional","affiliation":[{"name":"Health Services, Bristol-Myers Squibb Company, Plainsboro, NJ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ross A","family":"Baker","sequence":"additional","affiliation":[{"name":"CNS Global Medical Affairs, Otsuka Pharmaceutical Development and Commercialization, Inc., Princeton, NJ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert A","family":"Forbes","sequence":"additional","affiliation":[{"name":"CNS Global Medical Affairs, Neuroscience, Otsuka Pharmaceutical Development and Commercialization, Inc."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerry","family":"Oster","sequence":"additional","affiliation":[{"name":"Policy Analysis Inc."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2012,5,1]]},"reference":[{"key":"bibr1-aph.1Q326","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.23.3095"},{"key":"bibr2-aph.1Q326","doi-asserted-by":"crossref","first-page":"A34","DOI":"10.1176\/appi.ajp.2010.167.10.a34","volume":"167","author":"APA","year":"2010","journal-title":"Am J Psychiatry"},{"key":"bibr3-aph.1Q326","doi-asserted-by":"publisher","DOI":"10.1016\/S0193-953X(05)70283-5"},{"key":"bibr4-aph.1Q326","doi-asserted-by":"publisher","DOI":"10.1016\/S0163-8343(00)00072-4"},{"key":"bibr5-aph.1Q326","first-page":"370","volume":"16","author":"Gibson TB","year":"2010","journal-title":"Am J Manag Care"},{"key":"bibr6-aph.1Q326","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v68n0604"},{"key":"bibr7-aph.1Q326","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0b013e31816774f9"},{"key":"bibr8-aph.1Q326","doi-asserted-by":"publisher","DOI":"10.1017\/S1092852900020216"},{"key":"bibr9-aph.1Q326","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.08m04629"},{"key":"bibr10-aph.1Q326","doi-asserted-by":"publisher","DOI":"10.1017\/S1461145710000015"},{"key":"bibr11-aph.1Q326","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v68n0207"},{"key":"bibr12-aph.1Q326","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.134.4.382"},{"key":"bibr13-aph.1Q326","unstructured":"Analy$ource Online, http:\/\/www.analysource.com\/ (accessed 2005 Aug)."},{"key":"bibr14-aph.1Q326","volume-title":"Medicare Resource Based Relative Value Scale [RBRVS]","year":"2009"},{"key":"bibr15-aph.1Q326","doi-asserted-by":"publisher","DOI":"10.2307\/3001666"},{"key":"bibr16-aph.1Q326","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-6-50"},{"key":"bibr17-aph.1Q326","unstructured":"Bax L, Yu LM, Tsuruta H, Moons KGM. 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