Semester

Spring

Date of Graduation

2003

Document Type

Thesis

Degree Type

MS

College

School of Pharmacy

Department

Pharmaceutical Systems and Policy

Committee Chair

Virginia (Ginger) G. Scott.

Abstract

The objective of this study was to determine the cost-effectiveness of St. John's Wort compared to fluoxetine from a third party perspective for the treatment of mild to moderate depression. Fluoxetine 20 mg daily was compared to St. John's Wort 300 mg thrice daily in a decision tree modeling depression management in the outpatient setting. Probabilities were obtained from a Medline search as well as input from an expert panel. Direct medical costs were obtained from medical offices in the Connecticut area with drug and herb cost based on 2002 published data. Several sensitivity analyses were performed. The cost-effectiveness ratio for St. John's Wort was {dollar}1,788 per successful treatment compared to {dollar}2,043 for fluoxetine. Results were sensitive only to large fluctuations in cost of drug or herb therapy. Thus, St. John's Wort is a viable option for patients with mild to moderate depression.

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