Unipolar Depression | Landscape & Forecast | Disease Landscape & Forecast

Publish date: October 2018

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Unipolar depression’s very crowded generic therapy market makes it a challenge for branded agents to gain a strong foothold. SSRIs’ use as first-line treatments and continued position as the patient-share leaders contribute to the challenges that branded therapies face entering this market. However, the need for effective treatments that address the symptoms of the one-third of depression patients who are treatment-resistant is expected to drive growth as newer-to-market therapies (e.g., Lundbeck/Otsuka Pharmaceutical’s Rexulti/RXulti, Allergan’s Vraylar) are incorporated into the treatment paradigm and as emerging therapies targeting underserved cohorts of depression patients (e.g., Janssen’s esketamine, Allergan’s rapastinel, Alkermes’s ALKS-5461) enter the market.


  • What factors drive and constrain the use of branded antidepressants and atypical antipsychotics for the treatment of unipolar depression? What branded therapy is expected to experience the greatest commercial success during the 2017-2027 forecast period?
  • Given the crowded and highly genericized unipolar depression market, what is the commercial potential of key late-phase emerging therapies for unipolar depression?
  • What are the greatest areas of unmet need in the treatment of unipolar depression, and how are the emerging therapies expected to address these unmet needs?
  • Therapies with a more-rapid onset of action are a substantial unmet need in the treatment of unipolar depression. To what extent will emerging therapies, such as Janssen’s esketamine, Allergan’s rapastinel, and Alkermes’s ALKS-5461, capitalize on this unmet need? How will physicians likely incorporate these treatments into their clinical practice?

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

Primary research: Approximately 20 country-specific interviews with thought-leading psychiatrists and PCPs/GPs; supported by survey data collected for this and other DRG research.

Epidemiology: 12-month prevalence of unipolar depression by country, segmented by MDD, minor depression, and dysthymia; diagnosed and drug-treated cases of unipolar depression; 12-month prevalence of MDD by country, segmented by chronic pain status; 12-month prevalence of MDD by country, segmented by treatment-resistant status.

Emerging therapies: Phase II: 19 drugs; Phase III: 3 drugs; preregistration: 4 drugs. Coverage of 18 select preclinical and Phase I products.

Market forecast features: Patient-based market forecast extending from 2017 through 2027.

Key companies: Allergan, Alkermes, AstraZeneca, Axsome Therapeutics, Fabre-Kramer, Gedeon Richter, GlaxoSmithKline, Janssen, Lundbeck, Otsuka Pharmaceutical, Pfizer, Sage Therapeutics, Shionogi, Sumitomo Dainippon, Sunovion

Key drugs: Aripiprazole, bupropion HCl SR/XR, duloxetine, escitalopram, Latuda (lurasidone), quetiapine IR/XR, venlafaxine IR/XR, Rexulti/RXulti (brexpiprazole), Trintellix/Brintellix (vortioxetine), Vraylar (cariprazine), ALKS-5461, ASC-01, AXS-05, esketamine, gepirone ER, rapastinel, SAGE-217

Table of contents

  • Disease Landscape & Forecast
    • Key Updates
      • December 2018
      • November 2018
      • August 2018
      • May 2018
      • March 2018
    • Market Outlook
      • Key Findings
        • Market Overview
      • Market Drivers and Constraints
        • What Factors Are Driving the Market for Unipolar Depression?
        • What Factors Are Constraining the Market for Unipolar Depression?
      • Drug-Class-Specific Trends
        • Selective Serotonin Reuptake Inhibitors
        • Serotonin and Norepinephrine Reuptake Inhibitors
        • Atypical Antipsychotics
        • Mixed Serotonin Modulators
        • Opioid Receptor Modulators
        • NMDA Receptor Modulators
        • Serotonin Agonists
      • Alternative Market Scenarios
    • Forecast
      • Market Forecast Assumptions
      • Market Forecast Dashboard
    • Etiology and Pathophysiology
      • Disease Overview
      • Environmental Factors
      • Genetic Factors
      • Key Pathways and Drug Targets
    • Epidemiology Overview
      • Key Findings
      • Epidemiology Populations
        • 12-Month Prevalent Cases of Unipolar Depression
        • Comorbid Chronic Pain in Major Depressive Disorder
        • Treatment-Resistant Depression in MDD
        • Diagnosed 12-Month Prevalent Cases of Unipolar Depression
        • Drug-Treated 12-Month Prevalent Cases of Unipolar Depression
    • Current Treatment Overview
      • Key Findings
      • Treatment Goals
      • Key Current Therapies
        • Overview
        • Selective Serotonin Reuptake Inhibitors
        • Serotonin and Norepinephrine Reuptake Inhibitors
        • Mixed Serotonin Modulators
        • Dopaminergic/Noradrenergic Agents
        • Tricyclic and Tetracyclic Antidepressants
        • Monoamine Oxidase Inhibitors
        • Melatonin Receptor Agonists
        • Atypical Antipsychotics
        • Nonpharmacological Approaches
      • Medical Practice
        • Overview
        • Treatment Guidelines
        • Country/Region-Specific Treatment Practices
    • Unmet Need Overview
      • Current and Future Attainment of Unmet Needs in Unipolar Depression
    • Emerging Therapies Overview
      • Key Findings
        • Key Findings
      • Key Emerging Therapies
        • Notable Developments in the Late-Phase Pipeline for Unipolar Depression
        • GABA Receptor Modulators
        • Opioid Receptor Modulators
        • NMDA Receptor Modulators
        • Serotonin and Norepinephrine Reuptake Inhibitors
        • Serotonin Agonists
      • Early-Phase Pipeline Analysis
        • Notable Developments in the Early-Phase Pipeline for Unipolar Depression
    • Access and Reimbursement Overview
      • Region-Specific Reimbursement Practices
        • United States
        • EU5
        • Japan
      • Looking for More?
    • 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
      • Unipolar Depression Bibliography

Author(s): Lisa Cloonan, BA; Shilpa Thakur; Shefali Gulati, MBA Pharm

Lisa joined Decision Resources Group in 2015 as a business insights analyst for the Central Nervous System and Ophthalmology division. In this role, she analyzes the commercial opportunities for pharmacological therapies across the psychiatry space. Prior to joining Decision Resources Group, Lisa spent 6 years in clinical stroke research at Massachusetts General Hospital. While in the clinical research field, Lisa developed an expertise in neuroimaging analysis, as well as authored and co-authored articles on the influence of white matter hyperintensity burden on stroke risk and recovery. Lisa holds bachelor of arts from Connecticut College, where her course work focused on behavioral neuroscience.

Shilpa Thakur is a medical graduate with a from the Postgraduate Institute of Medical Education and Research with a specialization in epidemiology and biostatistics. She specializes in developing epidemiological forecasts for the multiple indications within the DRG syndicated portfolio. Prior to joining Decision Resources, she monitored HIV sentinel surveillance 2016-2017 in Himachal Pradesh. She also has worked on to see the patterns of Antimicrobial resistance in India.  

Shefali Gulati, Associate analyst, is part of the Central Nervous System, Pain, and Ophthalmology team at Decision Resources Group. She is responsible for performing extensive secondary market research and analysis for major pharmaceutical markets. She comes with one year of experience working on multiple client projects revolving around opportunity assessment, competitive landscape, pipeline analysis, and key product profiling. She holds a MBA degree in Pharmaceutical Management from the National Institute of Pharmaceutical Education and Research (NIPER) in India and Bachelor’s in Pharmacy from DIPSAR.