Economic evaluation of St. John's wort (Hypericum perforatum) for the treatment of mild to moderate depression

Solomon, D; Adams, J; Graves, N

Economic evaluation of St. John's wort (Hypericum perforatum) for the treatment of mild to moderate depression

Solomon, D Adams, J

Graves, N

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Publication Type:: Journal Article
Citation:: Journal of Affective Disorders, 2013, 148 (2-3), pp. 228 - 234
Issue Date:: 2013-06-01

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Field	Value	Language
dc.contributor.author	Solomon, D	en_US
dc.contributor.author	Adams, J https://orcid.org/0000-0002-9901-5717	en_US
dc.contributor.author	Graves, N	en_US
dc.date.available	2012-11-29	en_US
dc.date.issued	2013-06-01	en_US
dc.identifier.citation	Journal of Affective Disorders, 2013, 148 (2-3), pp. 228 - 234	en_US
dc.identifier.issn	0165-0327	en_US
dc.identifier.uri	http://hdl.handle.net/10453/26838
dc.description.abstract	Background: The burden of rising health care expenditures has created a demand for information regarding the clinical and economic outcomes associated with Complementary and Alternative Medicines. Clinical controlled trials have found St. John's wort to be as effective as antidepressants in the treatment of mild to moderate depression. The objective of this study was to develop a model to assess the cost-effectiveness of St. John's wort based on this evidence. Methods: A Markov model was constructed to estimate health and economic impacts of St. John's wort versus antidepressants. Outcomes were treatment costs, quality-adjusted life years (QALYs) and Net Monetary Benefits (NMB). Probabilistic analyses were conducted on key model parameters. Results: The average NMB across 5000 simulations identified St. John's wort as the strategy with the highest net benefit. The total cost savings for SJW were $359.66 and $202.56 per individual for venlafaxine and sertraline respectively, with a gain of 0.08 to 0.12 QALYs over the 72 weeks of the model. Limitations: A lack of direct comparative clinical trial data comparing SJW to venlafaxine and limited data with sertraline as a comparator was a major limitation. Conclusions: In this model, St. John's wort was shown to be a cost-effective alternative to generic antidepressants. Patients are more likely to receive treatment for a duration consistent with professional guidelines for treatment of major depression due to reduced incidence of adverse effects, improving outcomes. This represents an important option in the treatment of Major Depressive Disorder. © 2013 Elsevier B.V.	en_US
dc.relation.ispartof	Journal of Affective Disorders	en_US
dc.relation.isbasedon	10.1016/j.jad.2012.11.064	en_US
dc.subject.classification	Psychiatry	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Hypericum	en_US
dc.subject.mesh	Cyclohexanols	en_US
dc.subject.mesh	Sertraline	en_US
dc.subject.mesh	Antidepressive Agents	en_US
dc.subject.mesh	Plant Preparations	en_US
dc.subject.mesh	Treatment Outcome	en_US
dc.subject.mesh	Phytotherapy	en_US
dc.subject.mesh	Severity of Illness Index	en_US
dc.subject.mesh	Models, Economic	en_US
dc.subject.mesh	Markov Chains	en_US
dc.subject.mesh	Depressive Disorder	en_US
dc.subject.mesh	Depressive Disorder, Major	en_US
dc.subject.mesh	Adolescent	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Cost-Benefit Analysis	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Young Adult	en_US
dc.subject.mesh	Venlafaxine Hydrochloride	en_US
dc.title	Economic evaluation of St. John's wort (Hypericum perforatum) for the treatment of mild to moderate depression	en_US
dc.type	Journal Article
utslib.citation.volume	2-3	en_US
utslib.citation.volume	148	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	11 Medical and Health Sciences	en_US
utslib.for	17 Psychology and Cognitive Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	closed_access
pubs.issue	2-3	en_US
pubs.publication-status	Published	en_US
pubs.volume	148	en_US

Abstract:

Background: The burden of rising health care expenditures has created a demand for information regarding the clinical and economic outcomes associated with Complementary and Alternative Medicines. Clinical controlled trials have found St. John's wort to be as effective as antidepressants in the treatment of mild to moderate depression. The objective of this study was to develop a model to assess the cost-effectiveness of St. John's wort based on this evidence. Methods: A Markov model was constructed to estimate health and economic impacts of St. John's wort versus antidepressants. Outcomes were treatment costs, quality-adjusted life years (QALYs) and Net Monetary Benefits (NMB). Probabilistic analyses were conducted on key model parameters. Results: The average NMB across 5000 simulations identified St. John's wort as the strategy with the highest net benefit. The total cost savings for SJW were $359.66 and $202.56 per individual for venlafaxine and sertraline respectively, with a gain of 0.08 to 0.12 QALYs over the 72 weeks of the model. Limitations: A lack of direct comparative clinical trial data comparing SJW to venlafaxine and limited data with sertraline as a comparator was a major limitation. Conclusions: In this model, St. John's wort was shown to be a cost-effective alternative to generic antidepressants. Patients are more likely to receive treatment for a duration consistent with professional guidelines for treatment of major depression due to reduced incidence of adverse effects, improving outcomes. This represents an important option in the treatment of Major Depressive Disorder. © 2013 Elsevier B.V.

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http://hdl.handle.net/10453/26838