Unipolar depression—comprising major depressive disorder (MDD), minor depression, and dysthymia—is a highly prevalent psychiatric disorder affecting nearly 81 million individuals in the seven major markets under study (United States, France, Germany, Italy, Spain, United Kingdom, and Japan). Throughout our 2015-2025 study period, the unipolar depression therapy market will consist almost entirely of generic products that dominate treatment, particularly in the early lines. Only a few branded products—namely, Allergan’s vilazodone (Viibryd), Lundbeck/Takeda Pharmaceutical’s vortioxetine (Brintellix/Trintellix), Allergan/Pierre Fabre’s levomilnacipran (Fetzima), Otsuka Pharmaceutical/Lundbeck’s brexpiprazole, Allergan/Gedeon Richter/Mitsubishi Tanabe Pharma’s cariprazine (Vraylar), and Sumitomo Dainippon/Sunovion/Takeda Pharmaceutical’s lurasidone (Latuda)—will be competing for market share during the forecast period in this highly genericized space. Because of generic competition from current therapies, it is unlikely that any emerging drugs (, Janssen’s esketamine, Alkermes’s ALKS-5461, and Allergan’s rapastinel) will become dominating first-line treatments; however, low patient response rates and even lower remission rates following treatment with first-line therapies leave opportunity for adjunctive agents for MDD and for monotherapies targeting specific patient subpopulations, particularly those with treatment-resistant depression (TRD) or residual symptoms of depression.
The unipolar depression market will decline in the first years of our forecast period (2015-2016). What is causing this market decline? Will any new drugs enter the market during this time, and if so, what will be their place in the treatment armamentarium?
Starting in 2017, the depression market will begin to experience a slow but steady upswing, owing in large part to increasing uptake of some of the newly marketed depression therapies. Which new therapies will experience the most robust growth, and why? How do interviewed experts expect to incorporate these newer therapies into the depression treatment algorithm in the face of strong generic competition from many well-entrenched products?
In 2022, the depression market will have reached approximately $ billion (from a low of $ billion in 2016). Which drugs will be the market leaders in 2022? To what extent will patient share have shifted to newer agents from the older, inexpensive generic antidepressants, and what factors underlie this shift? Will there be any major changes in how depression is treated? Will any novel approaches to treating depression have reached the market?
Near the end of our forecast period (2022-2024), the depression market will again be in decline before it experiences a resurgence in sales in our final year of the forecast. What are the main reasons for this decline and the resurgence? Do any early-stage therapies have the potential to reverse this trend later in the forecast period? If so, where would such therapies fit into the treatment algorithm?