Introduction:Last Updated 4 February 2013
Throughout the 2011-2021 forecast period, the unipolar
depression market will consist almost entirely of generic products that will
dominate first- and even second-line treatment. Only a very small number of
branded products, including Forest Laboratories’ vilazodone (Viibryd),
Lundbeck/Takeda’s vortioxetine (formerly Lu-AA21004), Forest
Laboratories/Pierre Fabre’s levomilnacipran, Eli Lilly’s edivoxetine, and
Dainippon Sumitomo/Sunovion’s lurasidone (Latuda), will be competing for market
uptake. Although the age of the blockbuster antidepressant may be drawing to an
end for now, low patient response rates and even lower remission rates
following treatment with first-line therapies continue to create opportunity
for adjunctive agents as well as monotherapies targeted toward specific patient
populations, particularly treatment-resistant depression.
Questions Answered in This Report:
Late-stage emerging therapies consist largely of agents
targeting the monoaminergic system, and therefore, they have mechanisms of
action similar to those of existing antidepressants. What are interviewed
physicians’ opinions of emerging antidepressants?
The patient shares of aripiprazole (Bristol-Myers
Squibb/Otsuka’s Abilify), extended-release quetiapine (AstraZeneca’s Seroquel
XR/Seroquel XL/Seroquel Prolong, generics [in the United Kingdom]), and
lurasidone will increase throughout our study period as atypical antipsychotics
are increasingly used as adjunctive treatment strategies. How are physician
attitudes toward using atypical antipsychotics for the treatment of major
depressive disorder (MDD) evolving? Are atypical antipsychotics gaining
traction in the primary care setting for depression?
Lundbeck and Takeda have released positive data from several
Phase III trials of vortioxetine in MDD, including a relapse-prevention study
and another in elderly patients. Trials assessing vortioxetine’s effect on
sexual dysfunction and cognitive dysfunction are also ongoing. How do we
expect the companies to position this multimodal serotonergic antidepressant
when it launches?
Between 2011 and 2015, the unipolar depression market will
contract rapidly due to the loss of U.S. market exclusivity of escitalopram
(Lundbeck/Recordati/Almirall’s Cipralex/Seroplex/Entact/Esertia, Forest
Laboratories’ Lexapro, generics), duloxetine (Eli Lilly/Shionogi’s
Cymbalta/Xeristar), and aripiprazole, which will result in a loss of more than
$3.5 billion in sales to generic erosion. To what extent will emerging
therapies be able to recoup these lost sales? In which of the major
pharmaceutical markets will antidepressant sales still grow?
covered: United States, France, Germany, Italy, Spain, United Kingdom,
Primary research: 28 country-specific interviews with
key opinion leaders, psychiatrists, and primary care physicians.
Epidemiology: Twelve-month prevalence of the unipolar
depression population (consisting of patients with major depressive disorder,
minor depression, and dysthymia); treatment-resistant depression (stages 1, 2,
3, and 4); major depressive disorder comorbidity with chronic pain.
Emerging therapies: Phase II: 15 drugs; Phase
III/preregistration: 10 drugs. Summarized coverage of 8 select Phase I
Market forecast features: This report features an epidemiology-based
market forecast from 2011 to 2021 that encompasses the total number of patients
with unipolar depressive disorders, not just patients suffering from MDD.