A patient with major depressive disorder (MDD) who does not achieve adequate response to more than two different trials of antidepressant drugs is then usually considered as having treatment-resistant depression (TRD). The main goal of TRD treatment is to provide relief and ultimately complete remission from depressive symptoms in patients. Commonly prescribed drugs are aripiprazole (Otsuka Pharmaceutical’s Abilify, generics), bupropion SR (GlaxoSmithKline’s Wellbutrin SR/Elontril/Zyban, other brands, generics), citalopram (Allergan’s Celexa, Lundbeck’s Seropram/Cipramil, generics), duloxetine (Eli Lilly’s Cymbalta/Xeristar, generics), olanzapine/fluoxetine combination (Eli Lilly’s Symbyax, generics), quetiapine XR (AstraZeneca’s Seroquel Prolong/XR/LP, generics), and vortioxetine (Lundbeck/Takeda Pharmaceutical’s Trintellix, Lundbeck’s Brintellix). The goal of treatment with all of these agents is to provide adequate relief to patients, each of whom may respond differently to these therapies. Despite the availability of these agents in the United States and Europe to treat MDD/TRD, opportunity remains in the MDD market for new agents that can address existing unmet needs such as the need therapies with improved efficacy.

This Unmet Need content provides quantitative insight into U.S. and European psychiatrists’ perception of key treatment drivers and goals in the treatment of TRD and the current level of unmet need in this indication. We analyze the commercial opportunities and how emerging therapies may capitalize on these opportunities.

Questions Answered:

  • What are the treatment drivers and goals for TRD?
  • 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 TRD?
  • What are the prevailing areas of unmet need and opportunity in TRD?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European psychiatrists for a hypothetical new TRD drug?

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

Primary research: Survey of 60 U.S. and 31 European psychiatrists fielded in February 2017

Key companies: Allergan, AstraZeneca, Eli Lilly, GlaxoSmithKline, Lundbeck, Otsuka Pharmaceutical, Takeda Pharmaceutical

Key drugs: Aripiprazole, bupropion SR, citalopram, duloxetine, olanzapine/fluoxetine combination, quetiapine XR, and vortioxetine

Table of contents

  • Detailed, Expanded Analysis - Treatment-Resistant Depression (US & EU)
    • Key Updates
      • November 2017
      • September 2017
      • June 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
        • Convenience of Administration
      • Physician Rating of Treatment Drivers and Goals in TRD
        • Efficacy
        • Safety and Tolerability
        • Convenience of Administration
      • Stated vs. Derived Importance of Treatment Drivers and Goals
    • 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
        • Convenience of Administration
    • Assessment of Unmet Need
      • Overview
      • Overall Satisfaction with Current Treatment
      • Physician Rating of Unmet Need in TRD
        • Efficacy
        • Safety and Tolerability
        • Convenience of Administration
      • Unmet Need in TRD and Related Indications
    • Opportunity Analysis
      • Areas of Opportunity in the TRD Market and Emerging Therapy Insights
        • Opportunity: A New Therapy with Improvements on Several Key Efficacy Factors
        • Opportunity: A New Therapy Offering Faster Time to Onset of Therapeutic Effect
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
      • Attribute Importance and Part-Worth Utilities
        • TRD Target Product Profile: Attribute-Level Part-Worth Utilities
      • Conjoint Analysis-Based Simulations of Market Scenarios
        • Scenario 1
        • Scenario 2
        • Scenario 3
    • Appendix
      • Bibliography

Author(s): Audreza Das, P.G. Dip

Audreza Das is a Senior Analyst in the CNS/Ophthalmology team at Decision Resources Group She has authored content across indications, including neuropathic pain, age-related macular degeneration, treatment-related depression, painful diabetic neuropathy, and migraine. Ms. Das has previously worked at Novo Nordisk, as a Market Analyst for European markets. Previous experience at a SME, included developing disease competitive landscapes, covering global conferences etc. Ms. Das received her degree in Biotechnology from Birla Institute of Technology, a deemed university and her Diploma in Cancer Immunology & Biotechnology from University of Nottingham.


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