Generics Superior First-Line Antidepressant Therapy, Express Scripts Study Confirms

Mar 01, 2011, 08:00 ET from Express Scripts, Inc.

ST. LOUIS, March 1, 2011 /PRNewswire/ -- Patients who start on generic antidepressants are as likely to keep taking their medication as prescribed as those who start on brand-name drugs, an Express Scripts (Nasdaq: ESRX) study shows. The company's analysis provides further proof that greater use of generics could significantly reduce wasteful healthcare spending while maintaining positive health outcomes.


The study was published in the March issue of the Journal of Managed Care Pharmacy.  The journal publishes peer-reviewed original research manuscripts, subject reviews and other content intended to advance the use of the scientific method in managed care pharmacy.

Depression is a major cause of disability in the U.S. and accounts for more than $83 billion in costs annually, according to the Express Scripts 2009 Drug Trend Report.  Experts have long advocated that using generics could reduce pharmacy costs for healthcare payers, without leading to treatment failure or increased medical costs in the short term.

In the study, patients starting generic selective serotonin reuptake inhibitors (SSRIs) and generic selective norepinephrine reuptake inhibitors (SNRIs) had a discontinuation rate of 44.2 percent, compared to 46.8 percent among those on brand-name SSRIs and SNRIs.  However, drug costs for those starting on generics were almost 50 percent lower.  Total healthcare costs were about 20 percent lower - an average of $3,660 in patients starting on a generic compared to $4,587 for those starting on a brand-name drug.

The study has significant implications for plan sponsors looking to reduce costs while maintaining high levels of patient care, said Sharon Frazee, PhD, vice president of research and analytics for Express Scripts.  The study is part of Consumerology®, the advanced application of behavioral sciences to healthcare.

"When patients use medications that cost more without offering a clinical advantage, it causes waste in the system," Dr. Frazee said.  "Through Consumerology, Express Scripts eliminates that waste by helping patients make the best decisions for their physical and financial health."

The study analyzed antidepressant usage from more than 16,000 patient records in MarketScan®, a database of integrated pharmacy and medical claims from commercially insured patients.  The database removes identifying patient information from the records.  Although antidepressants have been researched extensively, the Express Scripts study is the first to compare discontinuation rates and healthcare costs between brands and generics.

Express Scripts' study validates previous findings that demonstrated similar effectiveness among brand and generic SSRIs.  The new research analyzes a wider range of antidepressants in a larger, more clinically representative sample and addresses concerns about aggressive management of the antidepressant class through programs such as Step Therapy.  Plan sponsors can use Step Therapy to help promote the use of generics within their pharmacy benefit programs to reduce costs while maintaining the highest levels of patient care.

For more information on the study, visit

About Express Scripts

Express Scripts, Inc., one of the largest pharmacy benefit management companies in North America, is leading the way toward creating better health and value for patients through Consumerology®, the advanced application of the behavioral sciences to healthcare.  This approach is helping millions of members realize greater healthcare outcomes and lowering cost by assisting in influencing their behavior.  Headquartered in St. Louis, Express Scripts provides integrated PBM services including network-pharmacy claims processing, home delivery services, specialty benefit management, benefit-design consultation, drug-utilization review, formulary management, and medical and drug data analysis services.  The company also distributes a full range of biopharmaceutical products and provides extensive cost-management and patient-care services.  More information can be found at and

Media Contact: Thom Gross

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SOURCE Express Scripts, Inc.