Comparison of Escitalopram and Citalopram

Managing Principals Paul E. Greenberg and Eric Wu led an Analysis Group team and a client in a comparison of escitalopram and citalopram for the treatment of major depressive disorder (MDD) in a geriatric population. The team studied administrative claims data for the years 2003-2005 that were analyzed for patients aged 65 years and over with at least one inpatient claim or two independent medical claims associated with MDD diagnosis. All analyses were first conducted descriptively, followed by multivariate analysis to control for patients' baseline characteristics, including patient age group, gender, comorbidities, number of prescription drugs used, and baseline medical service utilizations. The researchers found that escitalopram-treated patients were less likely to discontinue treatment or switch to another second-generation antidepressant compared to patients treated with citalopram. They also found that patients treated with escitalopram had a significantly lower hospitalization rate and 66% fewer hospitalization days. While escitalopram patients had comparable prescription drug costs, they had lower total medical service costs and lower total healthcare costs than citalopram patients ($11,434 vs. $20,601). Dr. Wu and Mr. Greenberg presented some of their findings in a discussion of branded vs. generic drugs before the Congressional Budget Office in January 2008. The study was published in Current Medical Research and Opinion (Vol. 24, No 9, 2008).