Parkinson’s disease (PD) is widely recognized as a motor disorder, but PD is also associated with a diverse set of nonmotor symptoms. Surveyed neurologists estimate that 20% of their PD patients experience psychosis, and DRG Epidemiology data suggest the percentage could be even higher. Few antipsychotic agents have been rigorously tested in the PD population, but prescribing of these agents is common; left untreated, psychosis can have a devastating effect on PD patients’ quality of life. One antipsychotic agent is approved for PD psychosis in the United States (Nuplazid) and one in Europe (clozapine), but clear unmet need remains. Understanding prescriber perceptions of the available on- and off-label options and the drivers of clinical decision-making in PD psychosis will help developers of antipsychotics and other agents gauge the market opportunity in PD and identify levers for new product positioning and differentiation in this underserved therapy market.


  • What drug attributes are most influential in prescribing for psychosis in the PD population? How do Nuplazid, clozapine, and commonly prescribed off-label agents perform on these attributes?
  • What are the specific areas of unmet need and opportunity in the treatment of PD psychosis?
  • Based on conjoint analysis and TPP simulation, what trade-offs between efficacy, safety, and price are neurologists willing to make for a hypothetical new antipsychotic agent for PD psychosis?


Unmet Need provides quantitative insight into U.S. and European physician perceptions of key treatment drivers and goals and the current level of unmet need for a specific disease. Commercial opportunities are analyzed, and the extent to which emerging therapies may capitalize on these opportunities is evaluated.

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

Primary research: Survey of 60 U.S. and 30 European neurologists, fielded in February 2020

Key drugs: Nuplazid (pimavanserin), clozapine, quetiapine, aripiprazole, olanzapine, risperidone, ziprasidone

Table of contents

  • Detailed, Expanded Analysis: Psychosis in PD (US/FR/DEU/UK)
    • Executive Summary
      • Unmet Need - PD Psychosis - Executive Summary - March 2020
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
      • 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 PD Psychosis
      • Key Findings: Unmet Need in PD Psychosis and Related Indications
    • Opportunity Analysis
      • Areas of Opportunity in the PD Psychosis Market and Emerging Therapy Insights
        • Opportunity: A Novel Agent Approved for Psychosis in PD
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
      • Attribute Importance and Part-Worth Utilities
        • PD Psychosis Target Product Profile: Attribute-Level Part-Worth Utilities
      • Conjoint Analysis-Based Simulation of a Market Scenario
        • Market Scenario
    • Appendix
      • Bibliography

Author(s): Bethany Christmann, PhD

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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