The highly entrenched generic market for major depressive disorder (MDD) patients poses a challenge for branded agents attempting to gain traction in the United States. The heterogeneous responses of MDD patients to well-ingrained antidepressants and/or atypical antipsychotics provide new branded agents with the opportunity to be incorporated into the well-established drug market. Due to the very crowded and competitive MDD landscape, understanding where the current players fit in the treatment algorithm is essential.


  • What patient shares do key therapies and brands garner by line of therapy in newly diagnosed MDD patients? What are the quarterly trends in prescribing among recently treated and newly diagnosed MDD patients?
  • How have Allergan’s Fetzima (levomilnacipran) and Lundbeck / Takeda’s Trintellix (vortioxetine) been integrated into the treatment algorithm, and what are their sources of business?
  • What percentage of MDD patients receive standards of care such as SSRIs (e.g., escitalopram [Lundbeck / Allergan’s Lexapro, generics]) or newer-to- market brands within one year of diagnosis, and how quickly? What percentage of patients progress to later lines of therapy within one year of diagnosis?
  • What percentage of MDD patients are treated with monotherapy versus combination therapy? What are the most commonly used combinations?
  • What are the product-level compliance and persistency rates among drug-treated patients?


Geography: United States

Real-world data: Longitudinal patient-level claims data analysis.

Key drugs covered: Aplenzin, Fetzima, Forfivo XL, Latuda, quetiapine, Rexulti, sertraline, Spravato, Trintellix, Vraylar

Key companies: Allergan, Almatica Pharma, Janssen Pharmaceuticals, Lundbeck, Otsuka, Sanofi, Sunovion, Takeda

Key analysis provided:

  • Brand / therapy usage across longitudinal patient sample.
  • Newly diagnosed patient analysis.
  • Treatment initiation and progression.
  • Line of therapy analysis.
  • Combination therapy analysis.
  • Source of business for recently treated patients.
  • Persistency and compliance analysis.
  • Product-level patient flowcharts.


Treatment Algorithms: Claims Data Analysis provides detailed, quantitative analysis of the treatment journey and brand usage across lines of therapy and overall using real-world, patient-level claims data so that marketers can accurately assess their source of business, benchmark usage against competitors, and quantify areas of opportunity for their marketed or emerging brand.

Table of contents

  • Unipolar Depression - Current Treatment - Detailed, Expanded Analysis: Treatment Algorithms: Claims Data Analysis (US)
    • Treatment Algorithms CDA Major Depressive Disorder US February 2020

Author(s): Bethany A. Kiernan, Ph.D.

Bethany A. Kiernan, Ph.D., is a senior director on the CNS/Ophthalmology Disorders team at DRG, part of Clarivate. She manages and supports a team of business insights analysts in producing both syndicated and custom market research analyses in a range of psychiatry and pain indications. Dr. Kiernan has extensive experience in market forecasting and broad knowledge across a range of CNS disorders, including depression, bipolar disorder, and chronic pain indications. Her previous experience includes eight years of scientific research conducted at Tufts University School of Medicine, Case Western Reserve University, and the College of the Holy Cross. She earned her doctorate in neurosciences from Case Western Reserve University.

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