Economic evaluation of citalopram use and expenditures among recipients in the Texas Medicaid program.

OBJECTIVE To describe the trends in the utilization and expenditures of selective serotonin reuptake inhibitors (SSRIs) and venlafaxine within the Texas Medicaid program in 1999 and 2000; more specifically, to compare the use of citalopram with other SSRI agents and venlafaxine. METHODS A retrospective analysis of Texas Medicaid paid prescription claims data involving Texas Medicaid clients aged 18 to 64. The main outcome measures were allowed, discounted cost per day; dose per day; treatment days (persistence); adherence rates; and switching rates. RESULTS Citalopram had a significantly lower calculated cost per day than all other comparator agents. There were no statistically significant differences between study agent groups when comparing treatment days and adherence days for newly started patients, except for lower rates with venlafaxine IR. CONCLUSIONS Within the Texas Medicaid Program, citalopram had a positive economic impact on prescription drug costs compared to other comparator agents, while showing similar outcomes in utilization measures such as treatment days and adherence rates.