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Department of Health Economics (DHE)

Cost-effectiveness of quetiapine-lamotrigine combination versus quetiapine monotherapy in bipolar depression: Economic evaluation of the CEQUEL trial

Date: 2013-2015
Funding: UK NIHR HTA
Collaborator(s): Department of Psychiatry, University of Oxford, UK
Information: Judit Simon (co-PI), Susanne Mayer

Although current monotherapies for bipolar depression remain limited in terms of proven efficacy and practical tolerability, it is hypothesized that combinations of treatments may lead to better outcomes. CEQUEL was designed to test if the strategy of combining lamotrigine with quetiapine results in greater improvement in depressive symptoms than quetiapine alone. By using a (partial) factorial design, CEQUEL also investigated the effects of adding folic acid which is a simple, widely available over-the-counter treatment with some evidence of efficacy in unipolar depression. The objective of this study was to assess the consequences of both treatment combinations in terms of quality of life and costs from the health and social care perspective and the broader societal perspective. A prospective within-trial economic evaluation was carried out alongside the UK CEQUEL Trial, aiming to analyze incremental costs, effects and cost-effectiveness of quetiapine plus lamotrigine combination therapy versus quetiapine monotherapy and incremental costs, effects and cost-effectiveness of folic acid versus placebo