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Impact of the STAR*D Trial From the Perspective of the Payer

Dr. Little is affiliated with the Center for Evidence-Based Policy, Oregon Health and Science University, 2611 SW 3rd Ave., MQ 280, Portland, OR 97201 (e-mail: littleal{at}ohsu.edu). Dr. Hansen is with the Division of Pharmaceutical Outcomes, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill. Dr. Gartlehner is with the Department of Evidence-Based Medicine and Clinical Epidemiology, Danube University, Krems, Austria. Ms. Gray is with the Bureau of Benefits Management, State of Wisconsin Division of Health Care Access and Accountability, Madison. This commentary is part of a special section on the STAR*D trial (Sequenced Treatment Alternatives to Relieve Depression) and the implications of its findings for practice and policy. Grayson S. Norquist, M.D., M.S.P.H., served as guest editor of the special section.

The authors discuss implications for private and public insurers of the STAR*D trial (Sequenced Treatment Alternatives to Relieve Depression), which found evidence that for second- and third-line treatment, no second-generation antidepressant was superior to another in terms of effectiveness or of the overall incidence of harmful effects. These findings have permitted payers to construct formulary coverage rules with more confidence and have highlighted the benefits of policies that improve access to care (for example, encouraging primary care treatment of depression) or promote treatment adherence (for example, implementing pay-for-performance initiatives).

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				G. S. Norquist Introduction to the STAR*D Special Section Psychiatr Serv, November 1, 2009; 60(11): 1437 - 1438. [Full Text] [PDF]

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