There is increased industry focus on the behavioral symptoms of Alzheimer’s disease (AD), including agitation—and with good reason. Agitation affects the majority of diagnosed AD patients, according to DRG epidemiology, and comprises a constellation of disruptive symptoms for patients and their families. With competing brands from Lundbeck/Otsuka, Avanir/Otsuka, and IntraCellular Therapies (among others) poised to enter the market beginning in 2021, and blockbuster sales at stake, understanding the drivers of clinical decision making in agitation and prescriber perceptions of the risk/benefits of today’s off-label (but generic) options will help identify levers for new product positioning and differentiation in this evolving market.

Questions Answered:

  • What are the treatment drivers and goals for agitation in AD?
  • What attributes are key influencers, which have limited impact, and which are hidden opportunities?
  • How do current therapies perform on key treatment drivers and goals for agitation in AD?
  • What are the prevailing areas of unmet need and opportunity in agitation in AD?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European neurologists for a hypothetical new agitation in AD drug?

Markets covered: United States, United Kingdom, France, Germany

Primary research: Survey of 60 U.S. and 30 European neurologists fielded in January 2017

Key companies: Lundbeck, Otsuka Pharmaceutical, Avanir Pharmaceuticals

Key drugs: quetiapine, risperidone, olanzapine, haloperidol, citalopram, arpiprazole, lorazepam, brexpiprazole, AVP-786

Table of contents

  • Detailed, Expanded Analysis: Agitation in Alzheimer's Disease
    • Key Updates
      • November 2017
    • Treatment Drivers and Goals
      • Overview
      • Treatment Drivers and Goals
        • Methodology
        • Physician Weighting of Clinical and Nonclinical Attributes
      • Rationale for Treatment Drivers and Goals Selection
        • Efficacy
        • Safety and Tolerability
      • Stated vs. Derived Importance of Treatment Drivers and Goals
      • Physician Rating of Treatment Drivers and Goals in Agitation in Alzheimer's Disease
        • Efficacy
        • Safety and Tolerability
    • Product Performance Against Treatment Drivers and Goals
      • Overview
      • Rationale for Drug Selection
      • Current Brand Performance on Key Treatment Drivers and Goals
        • Efficacy
        • Safety and Tolerability
    • Assessment of Unmet Need
      • Overview
      • Overall Satisfaction with Current Treatment
      • Unmet Need in Agitation in Alzheimer's Disease and Related Indications
      • Physician Rating of Unmet Need in Agitation in Alzheimer's Disease
        • Efficacy
        • Safety and Tolerability
    • Opportunity Analysis
      • Areas of Opportunity in the Agitation in Alzheimer's Disease Market and Emerging Therapy Insights
        • Opportunity: A Drug Approved for the Treatment of Agitation in Alzheimer's Disease
        • Opportunity: An Approved Therapy for Agitation in Alzheimer's Disease That Does Not Have a Safety Warning for Increased Mortality
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
      • Attribute Importance and Part-Worth Utilities
        • Agitation in Alzheimer's Disease Target Product Profile: Attribute-Level Part-Worth Utilities
      • Conjoint Analysis-Based Simulations of Market Scenarios
        • Scenario 1
    • Appendix
      • Experts Interviewed
      • Bibliography

Author(s): Tamara Blutstein, PhD

Tamara Blutstein is a Senior Business Insights Analyst on the Central Nervous System, Pain, and Ophthalmology team. She is responsible for analyzing and forecasting pharmaceutical markets, primarily in Neurology indications, with specific expertise in Alzheimer’s disease, Parkinson’s disease, and ischemic stroke. Prior to joining the company, Tamara was a postdoctoral fellow at Tufts University School of Medicine, where she studied the role of gliotransmission in the regulation of sleep and sleep homeostasis. She earned a in neuroscience from the University of Maryland School of Medicine where she conducted research on the role of gonadal hormones in modulating neuronal-glial communication. She holds a in neuroscience from Drew University.

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