Cost Comparison Table

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

Pharmacoeconomic Report: Esketamine Hydrochloride (Spravato): (Janssen Inc.): Indication: Major Depressive Disorder in Adults [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2021 Apr.

Cover of Pharmacoeconomic Report: Esketamine Hydrochloride (Spravato)

Pharmacoeconomic Report: Esketamine Hydrochloride (Spravato): (Janssen Inc.): Indication: Major Depressive Disorder in Adults [Internet].

Show details

Contents

< Prev Next >

Appendix 1Cost Comparison Table

The comparators presented in the following table have been deemed to be appropriate based on feedback from clinical expert(s). Comparators may be recommended (appropriate) practice or actual practice. Existing Product Listing Agreements are not reflected in the table and, as such, the table may not represent the actual costs to public drug plans.

Table 8CADTH Cost Comparison Table for Treatment-Resistant Major Depressive Disorder

Drug/comparator	Strength (mg)	Dosage form	Price ($)	Recommended dose (mg)	Average weekly drug cost ($)	Average annual drug cost ($)
Esketamine (Spravato)	28	Intranasal spray	273.0000^a	Week 1 to week 4: 2 sessions per week; day 1: 56; subsequent days: 56 or 84 Week 5 to week 8: 56 or 84 once weekly Weeks ≥ 9: 56 or 84 every 2 weeks or once weekly	Week 1: 1,092 to 1,365 Weeks 2 to 4: 1,092 to 1,638 Weeks 5 to 8: 546 to 819 Weeks ≥ 9: 273 to 819	Year 1: 18,564 to 45,591 ≥ 2 Years: 14,196 to 42,588
NMDA receptor antagonist
Ketamine (generic)	10 mg/mL 50 mg/mL	Vial	1.6454^b 5.1975^b	0.5 mg/kg intravenously infused for 40 minutes 1 to 3 times weekly^c	5.20 to 15.59^c	270 to 811^c
SNRIs
Desvenlafaxine (generic)	50 100	ER tablet	2.3409 2.3409	50 to 100 daily	16.39	854
Duloxetine (generic)	30 60	DR capsule	0.4814 0.9769	60 daily	6.84	357
Venlafaxine (generic)	37.5 75 150	ER capsule	0.0913 0.1825 0.1927	75 to 225 daily	1.28 to 2.63	67 to 137
SSRIs
Citalopram (generic)^d	20 40	Tablet	0.1332	20 to 60 daily	0.93 to 1.86	49 to 146
Escitalopram (generic)	10 20	OD tablet	1.3199 1.4052	10 to 20 daily	9.24 to 9.84	482 to 513
Escitalopram (generic)	10 20	Tablet	0.3109 0.3310	10 to 20 daily	2.18 to 2.32	114 to 121
Fluoxetine (generic)	10 20	Capsule	0.3404^e 0.3311	20 to 60 daily	2.32 to 2.98	121 to 363
Fluvoxamine (generic)^d	50 100	Tablet	0.2105 0.3783	100 to 300 daily^f	2.65 to 7.94	138 to 430
Paroxetine (generic)	20 30	Tablet	0.3250 0.3453	20 to 50 daily	2.28 to 4.69	119 to 245
Sertraline (generic)^d	25 50 100	Capsule	0.1516 0.3032 0.3303	50 to 200 daily	2.12 to 4.62	111 to 241
Vortioxetine (Trintellix)	5 10 20	Tablet	2.8148 2.9484 3.2011	10 to 20 daily	20.64 to 22.41	1,077 to 1,169
Norepinephrine -dopamine reuptake inhibitor
Bupropion (generic)	100 150	SR capsule	0.1547 0.2298	100 to 150 daily	1.08 to 1.61	57 to 84
Bupropion (generic)	150 300	ER capsule	0.1463 0.2927	150 to 300 daily	1.02 to 2.05	53 to 107
Alpha-2 adrenergic agonist
Mirtazapine (generic)^d	15 30 45	OD tablet	0.0975 0.1950 0.2925	15 to 45 daily	0.68 to 2.05	36 to 107
Mirtazapine (generic)^d	15 30 45	Tablet	0.0975^g 0.3100 0.2925^g	15 to 45 daily	0.68 to 2.05	36 to 107

: DR = delayed release; ER = extended release; NMDA = N-methyl-D-aspartate; OD = orally disintegrating; SNRI = serotonin-norepinephrine reuptake inhibitor; SR = sustained release; SSRI = selective serotonin reuptake inhibitor.
: Note: All prices are from the Ontario Drug Benefit Formulary (accessed February 2020) unless otherwise indicated and do not include dispensing fees.¹¹ Annual costs are based on 365 days per year.
a: Sponsor-submitted price.
b: BC PharmaCare Formulary (February 2020). Prices for 10 mg/mL vials ($1.7770) and 50 mg/mL vials ($5.6133) were reduced based on the 8% markup for non-high drugs (daily cost less than $40.00).²⁸
c: Dosing based on the mean baseline patient weight of 81.61 kg from the SUSTAIN-1 study and dose frequency based on clinical expert feedback. The current dosing is reflective of treatment in the acute phase, with reductions in dose (once weekly or once every 2 weeks) as part of maintenance.
d: Indicated for “depressive illness.”
e: Alberta Formulary (February 2020).²⁹
f: According to the fluvoxamine product monograph, dosages above 150 mg should be divided so a maximum of 150 mg is given as the bedtime dose.³⁰
g: Saskatchewan Formulary (February 2020).³¹

Table 9CADTH Cost Comparison Table for Treatment-Resistant Major Depressive Disorder – Second-Line or Third-Line Treatment

Drug/comparator	Strength (mg)	Dosage form	Price ($)	Recommended dose (mg)	Average weekly drug cost ($)	Average annual drug cost ($)
SNRIs (second line)
Levomilnacipran (Fetzima)	20 40 80 120	ER capsule	3.7007^a 3.8400^a 4.0947^a 4.3720^a	40 to 120 daily	26.88 to 30.60	1,401 to 1,596
Serotonin reuptake inhibitors (second line)
Trazodone (generic)^b	50 100 150	Tablet	0.0554 0.0989 0.1453	150 to 300 daily	1.02 to 2.03	61 to 106
Vilazodone (Viibryd)	10 20 40	FC tab IR tab IR tab	3.1257^a 3.1257^a 4.1603^a	20 to 40 daily	21.88 to 29.12	1,141 to 1,519
Reversible MAO-A inhibitor (second line)
Moclobemide (generic)^b	100 150 300	Tablet	0.3400 0.5295 1.0399	300 to 600 daily	7.28 to 14.56	380 to 760
Tricyclic antidepressants (second line)
Amitriptyline (generic)^b	10 25 50 75	Tablet	0.0435 0.0829 0.1540 0.3634^c	75 to 150 daily	2.54 to 3.23	91 to 169
Clomipramine (generic)^b	10 25 50	Tablet	0.2949 0.4020 0.7401	25 to 200 daily	2.81 to 20.72	147 to 1,081
Desipramine (generic)^b	10 25 50 75 100	Tablet	0.4056^d 0.3880 0.6838 0.9093 0.9507^d	100 to 300 daily	6.65 to 19.96	347 to 1,042
Doxepin (generic)^b	10 25 50 75 100	Capsule	0.2397 0.2940 0.5455 0.8066 1.3438	100 to 150 daily	7.64 to 11.29	398 to 589
Imipramine (generic)^b	10 25 50 75	Tablet	0.1397 0.2573 0.5021 0.6727^c	25 to 200 daily	1.80 to 12.93	94 to 674
Nortriptyline (Aventyl)^b	10 25	Capsule	0.2570 0.5193	75 to 100 daily	10.91 to 14.54	569 to 759
Trimipramine (generic)^b	12.5 25 50 75 100	Tablet Tablet Tablet Capsule Tablet	0.2156 0.2960 0.5795 0.7800 0.9889	150 to 300 daily	10.98 to 20.77	572 to 1,083
Irreversible MAO inhibitor (third line)
Phenelzine (Nardil)	15	Tablet	0.4667	45 to 90 daily	9.80 to 19.60	511 to 1,023
Tranylcypromine (Parnate)^b	10	Tablet	0.4055	20 to 60 daily	5.68 to 17.03	296 to 889

: ER = extended release; FC = film coated; IR = immediate release; MOA = monoamine oxidase; SNRI = serotonin-norepinephrine reuptake inhibitor.
: Note: All prices are from the Ontario Drug Benefit Formulary (accessed February 2020) unless otherwise indicated and do not include dispensing fees.¹¹ Annual costs are based on 365 days per year.
a: National wholesale price from Delta PA (accessed February 2020).³²
b: Indicated for “depressive illness.”
c: Alberta Formulary (accessed February 2020).²⁹
d: Saskatchewan Formulary (accessed February 2020).³¹

Table 10CADTH Cost Comparison Table for Treatment-Resistant Major Depressive Disorder – Adjunctive Treatment

Drug/comparator	Strength (mg)	Dosage form	Price ($)	Recommended dose (mg)	Average weekly drug cost ($)	Average annual drug cost ($)
First line
Aripiprazole (generic)	2 5 10 15 20 30	Tablet	0.8092 0.9046 1.0754 1.2692 1.0017 1.0017	2 to 15 daily	5.66 to 8.88	296 to 464
Quetiapine (generic)^a	50 150 200 300 400	IR tablet	0.2501 0.4926 0.6661 0.9776 1.3270	150 to 300 daily	3.45 to 6.84	180 to 357
Risperidone (generic)^a	0.25 0.5 1 2 3 4	Tablet	0.1036 0.1735 0.2397 0.4795 0.7180 0.9574	1 to 3 daily	1.68 to 5.03	87 to 262
Second line
Bupropion (generic)	100 150	SR capsule	0.1547 0.2298	100 to 150 daily	1.08 to 1.61	57 to 84
Bupropion (generic)	150 300	ER capsule	0.1463 0.2927	150 to 300 daily	1.02 to 2.05	53 to 107
Liothyronine (Cytomel)^a	5 mcg 25 mcg	Tablet	1.3632^b 1.4818^b	25 mcg to 50 mcg daily	10.37 to 20.75	541 to 1,082
Lithium carbonate (generic)^a	150 300	Capsule	0.0667 0.0657	600 to 1,200 daily	0.92 to 1.84	48 to 96
Mirtazapine (generic)^a	15 30 45	OD tablet	0.0975 0.1950 0.2925	15 to 45 daily	0.68 to 2.05	36 to 107
Mirtazapine (generic)^a	15 30 45	Tablet	0.0975^c 0.3100 0.2925^c	15 to 45 daily	0.68 to 2.05	36 to 107
Modafinil (generic)^a	100	Tablet	0.9293	100 to 400 daily	6.51 to 26.02	339 to 1,357
Olanzapine (generic)^a	2.5 5 7.5 10 15	Tablet	0.1772 0.3544 0.5316 0.7088 1.0631	2.5 to 10	1.24 to 4.96	65 to 259
Olanzapine (generic)^a	5 10 15	OD tablet	0.3574 0.7143 1.0711	2.5 to 10	5.00	261
Third line (psychostimulants)
Methylphenidate (generic)	18 27 36 54	IR tablet	0.5246 0.6055 0.6863 0.8479	18 to 54 daily^d	3.67 to 5.94	191 to 309

: CANMAT = Canadian Network for Mood and Anxiety Treatments; ER = extended release; IR = immediate release; OD = orally disintegrating; SR = sustained release.
: Note: All prices are from the Ontario Drug Benefit Formulary (accessed February 2020) unless otherwise indicated and do not include dispensing fees.¹¹ Annual costs are based on 365 days per year. Comparators were based on atypical antipsychotic drugs recommended as adjunctive agents for nonresponse or partial response to an antidepressant as listed in the CANMAT 2016 Guidelines.⁸
a: Dosing from the CANMAT 2016 Guidelines.⁸
b: Alberta Formulary (accessed February 2020).²⁹
c: Saskatchewan Formulary (accessed February 2020).³¹
d: Dosing obtained from the study by Ravindran et al. (accessed 2008).³³

The copyright and other intellectual property rights in this document are owned by CADTH and its licensors. These rights are protected by the Canadian Copyright Act and other national and international laws and agreements. Users are permitted to make copies of this document for non-commercial purposes only, provided it is not modified when reproduced and appropriate credit is given to CADTH and its licensors.

Except where otherwise noted, this work is distributed under the terms of a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International licence (CC BY-NC-ND), a copy of which is available at http://creativecommons.org/licenses/by-nc-nd/4.0/

Bookshelf ID: NBK572205

Contents

< Prev Next >

PubReader
Print View
Cite this Page
Pharmacoeconomic Report: Esketamine Hydrochloride (Spravato): (Janssen Inc.): Indication: Major Depressive Disorder in Adults [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2021 Apr. Appendix 1, Cost Comparison Table.
PDF version of this title (936K)

Other titles in this collection

CADTH Common Drug Reviews

Recent Activity

Clear Turn Off Turn On

Cost Comparison Table - Pharmacoeconomic Report: Esketamine Hydrochloride (Sprav...
Cost Comparison Table - Pharmacoeconomic Report: Esketamine Hydrochloride (Spravato)

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

Bookshelf