Epilepsy, which afflicts approximately 4.7 million people in the major markets according to DRG epidemiology, is a heterogeneous condition requiring individualized treatment based largely on a patient’s seizure syndrome and seizure type. The epilepsy therapy market already comprises more than 25 antiepileptic drugs (AEDs), most of them generic, that can be effective for many patients. In this challenging market environment, most developers are targeting underserved, orphan pediatric epilepsy populations, or they are developing reformulations of existing products as rescue therapies as a path to differentiation. Understanding the trajectory of the established epilepsy market and the evolving competitive landscape in niche segments is critical for marketers of both current and emerging brands to retain market share or carve out a clinical role.

Questions Answered:

  • What is the current state of treatment in epilepsy across the G7, and what needs are left unfulfilled by approved AEDs?
  • What are the market opportunities and sales potential for agents targeting treatment-refractory focal epilepsy (e.g., cenobamate, padsevonil) and for agents targeting orphan epilepsy subpopulations (e.g., Epidiolex, Fintepla)?
  • What clinical role will recently approved (e.g., Nayzilam, Valtoco) and emerging acute rescue therapies (e.g., Libervant) play in the epilepsy market?
  • How will neurologists differentiate among current and emerging third-generation AEDs, and which of these agents will enjoy the most clinical and commercial success in the face of strong generics competition from first- and second-generation AEDs?

Markets covered: United States, France, Germany, Italy, Spain, United Kingdom, Japan.

Primary research: Approximately 20 country-specific interviews with thought-leading neurologists, supported by survey data collected for this content and other DRG research.

Epidemiology: Diagnosed prevalence of epilepsy by country, segmented by generalized and partial-onset seizures; drug-treated cases.

Emerging therapies: Phase III/PR: 5 drugs; coverage of select II products.

Market forecast features: Patient-based market forecast extending through 2028, segmented by brands/generics.

Key companies: Aquestive Therapeutics, Bial, Eisai, GW Pharmaceuticals, Lundbeck, Marinus Pharmaceuticals, Neurelis, Sanofi, SK Biopharmaceuticals, Sunovion, UCB, Zogenix.

Key drugs: Levetiracetam, lamotrigine, carbamazepine, valproates, Vimpat (lacosamide), Aptiom/Zebinix (eslicarbazepine acetate), Fycompa (perampanel), Briviact (brivaracetam), Epidiolex (CBD), Fintepla (fenfluramine), YKP-3089 (cenobamate), UCB-0942 (padsevonil), Nayzilam (intranasal midazolam), Libervant (buccal diazepam), Valtoco (intranasal diazepam).

Table of contents

  • Disease Landscape & Forecast
    • COVID-19
    • Key Findings
      • Epilepsy - Key Findings - June 2020
    • Key Updates
      • June 2020
      • March 2020
      • December 2019
      • August 2019
    • Market Outlook
      • Key Findings
      • COVID-19: Areas of Potential Forecast Impact
      • Market Drivers and Constraints
        • What Factors Are Driving the Market for Epilepsy?
        • What Factors Are Constraining the Market for Epilepsy?
      • Drug-Class-Specific Trends
        • First-Generation AEDs
        • Second-Generation AEDs
        • Third-Generation AEDs
        • Outpatient Rescue Therapies
    • Forecast
      • Market Forecast Assumptions
      • Market Forecast Dashboard
    • Etiology and Pathophysiology
      • Disease Overview
      • Classification of Seizures and Epilepsies
      • Etiology
      • Pathophysiology
      • Key Pathways and Drug Targets
    • Epidemiology
      • Key Findings
      • Epidemiology Populations
        • Diagnosed Prevalent Cases of Epilepsy
        • Drug-Treated Cases of Epilepsy
    • Current Treatment
      • Key Findings
      • Treatment Goals
      • Key Current Therapies
        • Overview
        • First-Generation AEDs
        • Second-Generation AEDs
        • Third-Generation AEDs
        • Outpatient Rescue Therapies
      • Medical Practice
        • Overview
        • Region-Specific Treatment Practices
    • Unmet Need Overview
      • Current and Future Attainment of Unmet Needs in Epilepsy
    • Emerging Therapies
      • Key Findings
      • Key Emerging Therapies
        • Therapies for Partial-Onset Seizures
        • Therapies for Seizures in Pediatric Orphan Epilepsy Syndromes
        • Outpatient Rescue Therapies
      • Early-Phase Pipeline Analysis
    • Access & Reimbursement Overview
      • Region-Specific Reimbursement Practices
        • United States
        • EU5
        • Japan
    • Methodology
      • Bottom-Up Forecasting Overview
        • Patient Populations
        • Drug-Specific Assumptions
      • Bottom-Up Forecast Assumptions
        • General Sources of Data
        • Agents Included in Our Market Analysis
        • General Statements About Pricing
        • Dosing, Days of Therapy, and Compliance
        • Generic Erosion
        • Out-Year Forecasting
        • Emerging Therapy Prices
      • Primary Market Research
        • Experts Interviewed
    • Appendix
      • Epilepsy Bibliography

Author(s): Niyati Khetarpal, Ph.D; Abey John, MPH; Bethany Christmann, PhD

"Niyati Khetarpal  is an analyst on the Central Nervous System, Pain, and Ophthalmology team at ;In this role, she conducts extensive secondary research to analyze and forecast pharmaceutical markets, with specific expertise in patent research. Prior to joining the company, Niyati obtained her doctorate from the International Centre for Genetic Engineering and Biotechnology for her research on Dengue virus vaccines. She received the Fulbright-Nehru doctoral scholarship in 2014 for her research on Dengue and West Nile virus envelope ;

Abey John is a medical graduate with a Master’s in Public Health and has been associated with DRG since September 2015. He works with a global team of epidemiologists in performing systematic reviews of assigned diseases and prepare forecast models for clients. He also is involved in producing analyses for pharmaceutical drug developers on the descriptive epidemiology of major drug indications in mature and developing markets and have an overall experience of three years working in different healthcare sectors across the country. Prior to joining DRG, Abey had been working with Jhpiego (an affiliate of Johns Hopkins Medical University) in implementing Family Planning Health Programs in India with collaborating with the Government of India. He also has worked with a grassroots level NGO as a health team manager which worked for the benefit of the rural population living in the foothills of the Himalayas.

Bethany Christmann, has been with DRG since 2015, and is a Senior Business Insights Analyst with the Central Nervous System/Ophthalmology team. In this role, she covers the neurology space, specializing in Parkinson’s disease and epilepsy; she provides expert insight and authors primary market research and forecasting content focused on these and other neurology indications. Prior to joining DRG, Bethany earned her in neuroscience from Brandeis University, where she studied the cellular interactions involved in memory consolidation and their link to sleep behavior.


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