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Equal on Average Does Not Mean Equal for Everyone

Gregory Simon, MD,MPH

JAMA. 2001;286:3003-3004.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Patients, physicians, health insurers, and pharmaceutical manufacturers all have a considerable interest in the initial selection of an antidepressant drug. Patients and physicians hope to minimize the trial and error needed to find the treatment with the greatest benefit and the fewest risks or adverse effects. Health insurers hope to satisfy patients and insurance purchasers while minimizing drug acquisition costs. Manufacturers hope to demonstrate a unique advantage for a specific drug, either for all patients or specific subgroups of patients. Such an advantage would reduce the need to compete based on lowest price.

The study by Kroenke et al¹ in this issue of THE JOURNAL compared the effectiveness of the 3 most commonly prescribed selective serotonin reuptake inhibitor (SSRI) antidepressants (fluoxetine, paroxetine, and sertraline) among primary care patients initiating antidepressant treatment. In designing this randomized trial, the investigators attempted to replicate the conditions of everyday practice. Participating . . . [Full Text of this Article]

Author Affiliation: Center for Health Studies, Group Health Cooperative, Seattle, Wash.

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