Insomnia is a highly prevalent sleep disorder characterized by daytime dysfunction resulting from sleep problems. The treatment of insomnia is highly individualized, and physicians consider multiple factors when selecting an appropriate treatment regimen. Despite the availability of numerous pharmacological agents from a variety of drug classes, commercial opportunity remains for therapies that offer improved efficacy and/or improved safety and tolerability—including improved next-day functioning and a lower risk of next-day effects—over available treatments. Considering the long-standing market availability and low prices of generic sedatives and antidepressants commonly used for insomnia, emerging therapies will face obstacles to market access unless they can provide a compelling clinical and economic proposition.


  • What are surveyed psychiatrists’ opinions of the relative performance of select therapies, including zolpidem IR, ramelteon (Takeda’s Rozerem), and suvorexant (Merck & Co.’s Belsomra) on key efficacy, safety/tolerability, and convenience of administration attributes?
  • Based on the responses of surveyed psychiatrists, what level of unmet need exists on key drug performance attributes?
  • What attributes drive decision-making in the treatment of insomnia, which have limited impact, and which are hidden opportunities?
  • What trade-offs between efficacy, safety, convenience of administration, and price are acceptable to psychiatrists for a hypothetical new drug to treat insomnia?

Geographies: United States, United Kingdom, France, Germany

Primary research: Survey of 60 U.S. and 30 European psychiatrists fielded in January 2019

Key drugs covered: Belsomra, doxepin (Silenor, generics), trazodone, Rozerem, and zolpidem IR

Key metrics included: Target Product Profile (TPP) simulator based on conjoint analysis methodology, stated versus derived importance of product attributes on prescribing behavior, assessment of current drug performance against treatment drivers and goals, physician perceptions of unmet needs in the indication and related indications, and analysis of remaining drug development opportunities


Unmet Need supports clinical development decisions by identifying key attributes and assessing areas of unmet need for a specific disease or subpopulation. Based on surveys with U.S. and European physicians, this report provides insight into key treatment drivers and goals, the performance of current therapies, and the remaining commercial opportunities. Two market scenarios are profiled in detail by DRG experts, and additional customized market scenarios can be evaluated with the corresponding TPP simulator.

Table of contents

  • Detailed, Expanded Analysis (US/EU5)
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Efficacy
        • Safety and Tolerability
        • Convenience of Administration
      • Rationale for Drug Selection
    • Treatment Drivers and Goals
      • Key Findings: Attribute Importance
      • Key Findings: Stated vs. Derived Importance
    • Product Performance Against Treatment Drivers and Goals
      • Key Findings
    • Assessment of Unmet Need
      • Key Findings: Unmet Need in Insomnia
      • Key Findings: Unmet Need in Insomnia and Related Indications
    • Opportunity Analysis
      • Areas of Opportunity in the Insomnia Market and Emerging Therapy Insights
        • Opportunity: Insomnia Therapies That Improve Daytime Functioning
        • Opportunity: Drugs Lacking Residual Next-Day Side Effects
        • Opportunity: Drugs for the Treatment of Chronic Insomnia That Lack Abuse Potential
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
      • Attribute Importance and Part-Worth Utilities
        • Insomnia Target Product Profile: Attribute-Level Part-Worth Utilities
      • Conjoint Analysis-Based Simulations of Market Scenarios
        • Scenario 1
        • Scenario 2
    • Appendix
      • Experts Interviewed
      • Bibliography

Author(s): Natalie Taylor, PhD

Natalie Taylor, is a Principal Business Insights Analyst with the central nervous system/ophthalmology disorders team at Decision Resources Group. She has over ten years of experience authoring primary and market research reports for pharmaceutical industry clients across multiple psychiatry, pain, neurology, and ophthalmology therapy areas. Prior to joining DRG, Dr. Taylor worked at QuintilesIMS as manager of the central nervous system portfolio of Disease Insights market forecasting offerings. She completed her in Physiology at Dartmouth College in Hanover, New Hampshire, where she studied the role of serotonergic neurons in the medullary raphe on modulating respiratory responses in mammals. She holds a in Biology from Dickinson College in Carlisle, Pennsylvania.

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