Schizophrenia is a chronic and disabling psychiatric condition that affects approximately 1.8 million Americans. Patients with schizophrenia can present with a range of symptoms that are categorized into one of the three symptom domains: positive symptoms (e.g., hallucination, psychosis), negative symptoms (e.g., social withdrawal, apathy, anhedonia), and CIAS (e.g., loss of verbal fluency, memory, attention). Even though schizophrenia is a highly drug-treated indication, treatment is extremely individualized due to patients’ variable response to approved antipsychotic therapies. The Current Treatment Overview summarizes how psychiatrists presently treat schizophrenia across the G7 markets, while the detailed analysis examines U.S. psychiatrists’ current treatment practices and the motivations behind their prescribing decisions.

Table of contents

  • Schizophrenia - Current Treatment - Detailed, Expanded Analysis (US)
    • Physician Prescribing Practices
      • Key Findings
      • Patient Characteristics
        • Schizophrenia Is a Heterogeneous Condition
        • Percentage of Patients with Schizophrenia First Diagnosed by a Select Specialty (Survey Data)
        • Distribution of Patients with Schizophrenia Presenting with Each Symptom Domain (Survey Data)
        • Distribution of Patients with Schizophrenia by Insurance Type (Survey Data)
        • Age Distribution of Patients Diagnosed with Schizophrenia (RWD: EHR)
        • Percentage of Patients with Schizophrenia by Comorbidity and Other Attributes (Survey Data)
      • Treatment Practices
        • Antipsychotics Treat Comorbidities and Positive Symptoms of Schizophrenia
        • Percentage of Psychiatrists Who Prescribe Select Antipsychotic Formulations (Survey Data)
        • Long-Term Maintenance Treatment Begins Once Acute Symptoms Are Controlled
        • Time (in Weeks) to Long-Term Maintenance Treatment Initiation (Survey Data)
        • Time to Treatment Initiation Among Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Pharmacological Treatment for Schizophrenia Is Nearly a Universal Practice
        • Percentage of Drug-Treated Patients with Schizophrenia (Survey Data)
        • Treatment Rate for Patients Diagnosed with Schizophrenia (RWD: EHR)
        • Percentage of Drug-Treated Patients with TRS (Survey Data)
        • Surveyed Psychiatrists' Definition of Treatment Failure (Survey Data)
        • Treatment Paradigm for Treatment Failure (Survey Data)
        • Percentage of Schizophrenia Patients Treated with Pharmacological Therapy for CIAS and for Negative Symptoms (Survey Data)
        • Psychiatrists Prefer to Prescribe Oral Atypical Antipsychotics
        • Patient Share by Product (Survey Data)
        • Select Antipsychotics' Efficacy Influences Treatment Duration
        • Treatment Duration (in Weeks) by Product (Survey Data)
        • Nonpharmacological Therapies Treat Residual and Uncontrolled Symptoms of Schizophrenia
        • Percentage of Psychiatrists Who Prescribe Select Nonpharmacological Therapies (Survey Data)
        • Antipsychotics' Risk/Benefit Profiles Influence Placement Within the Treatment Paradigm
        • Surveyed Psychiatrists' Schizophrenia Patients Are Equally Distributed Across All Lines of Therapy
        • Percentage of Patients with Schizophrenia on Each Line of Therapy (Survey Data)
        • Half of All Schizophrenia Patients Progress Between Lines of Treatment
        • Percentage of Patients Who Progress to the Next Line of Therapy (Survey Data)
        • Progression Rates from First-Line Therapy Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Progression Rates from Second-Line Therapy Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Oral Atypical Antipsychotics Are Preferred Across All Lines of Therapy
        • Product Patient Share by Line of Therapy (Survey Data)
        • Patient Share by Line of Therapy for Products Used to Treat CIAS (Survey Data)
        • Patient Share by Line of Therapy for Products Used to Treat Negative Symptoms (Survey Data)
        • Treatment Duration Lengthens as Patients Progress Through Each Line of Therapy
        • Product Treatment Duration (in Weeks) by Line of Therapy (Survey Data)
        • Polypharmacy Is Predominately Used in Third-Line Therapy
        • Polypharmacy Use by Line of Therapy (Survey Data)
        • Drug Burden by Line of Therapy Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Psychiatrists' Most Commonly Prescribed Drug Combinations (Survey Data)
        • Off-Label Therapies Used Across All Lines of Treatment
        • Use of Monotherapies and Adjunctive Therapies: CIAS and Negative Symptoms (Survey Data)
        • Prescribed Off-Label Drug Classes: CIAS and Negative Symptoms (Survey Data)
      • Persistency and Compliance
        • Method of Administration Influences Schizophrenia Patients' Adherence
        • Schizophrenia Patients' Persistency Rates by Therapy (Survey Data)
        • Persistency by Product Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Schizophrenia Patients' Compliancy Rates by Therapy (Survey Data)
        • Average Duration of Therapy by Product (Survey Data)
      • Sequencing of Treatment
        • Treatment Sequencing Depends in Part on the Antipsychotic's Formulation
        • Source of Schizophrenia Patients Who Have Initiated Select Branded Atypical Antipsychotics (Survey Data)
        • Treatment Flow of Schizophrenia Patients Who Discontinued Select Branded Atypical Antipsychotics (Survey Data)
        • Common Treatment Patterns Following Select Antipsychotic Therapies' Discontinuation (Survey Data)
      • Recent/Anticipated Changes in Brand Use/Treatment Approach
        • Use of Atypical Antipsychotics Continues to Grow
        • Change in Use of Select Antipsychotic Therapies Within the Past Year (Survey Data)
        • Projected Patient Share of Select Antipsychotic Therapies Within One Year (Survey Data)
    • Physician Insight on Medical Practice
      • Key Findings
      • Drivers of Treatment Selection
        • Efficacy and Tolerability Drive Psychiatrists' Use of Antipsychotics in Schizophrenia
        • Prior Clinical Experience with an Antipsychotic Influences Prescribing Habits
        • Factors Influencing Psychiatrists' Choice of an Antipsychotic (Survey Data)
        • Factors Influencing the Addition of an Adjunct Therapy to an Antipsychotic (Survey Data)
        • Individualization of Treatment Highlights the Importance of Antipsychotics' Efficacy
        • Factors That Influence Psychiatrists' Use of Select Branded Oral Atypical Antipsychotics (Survey Data)
        • Factors That Influence Psychiatrists' Use of Select Branded Atypical Antipsychotic Depots (Survey Data)
        • Market Genericization Increases the Importance of Antipsychotics' Cost on Prescribing Decisions
        • Factors That Constrain Psychiatrists' Use of Select Branded Oral Atypical Antipsychotics: Prescribers and Nonprescribers (Survey Data)
        • Factors That Constrain Psychiatrists' Use of Select Branded Atypical Antipsychotic Depots: Prescribers and Nonprescribers (Survey Data)
        • Antipsychotics' Tolerability Contributes to Patients' Compliance with Therapy
        • Reasons Why Psychiatrists Switch to Select Branded Atypical Antipsychotics (Survey Data)
        • Reasons Why Psychiatrists Switch from Select Atypical Antipsychotics (Survey Data)
        • Clinical and Nonclinical Attributes Contribute to Schizophrenia Patients' Treatment Discontinuation
        • Reasons for Discontinuation of Pharmacological Treatment for Schizophrenia: Oral and Depot Therapies (Survey Data)
        • Treatment Deferral for Schizophrenia is Uncommon Among Psychiatrists
        • Reasons for Deferral of Pharmacological Treatment for Schizophrenia (Survey Data)
      • Face-to-Face Product Detailing Effectiveness
        • Sales Representatives Encourage Psychiatrists to Prescribe Branded Antipsychotics
        • Average Number of Detailing Visits Varies Across the Select Branded Antipsychotics
        • Sales Representatives' Access to Psychiatrists in the Clinical Setting (Survey Data)
        • Sales Representatives' Visitation Frequency: Branded Therapy (Survey Data)
        • Sales Representatives' Monthly Detailing Reach: Branded Therapy (Survey Data)
        • Psychiatrists Are Highly Satisfied with Sales Representatives' Knowledge
        • Psychiatrists' Satisfaction with Sales Representatives' Knowledge of Abilify Maintena (Survey Data)
        • Psychiatrists' Satisfaction with Sales Representatives' Knowledge of Aristada (Survey Data)
        • Psychiatrists' Satisfaction with Sales Representatives' Knowledge of Invega Sustenna (Survey Data)
        • Psychiatrists' Satisfaction with Sales Representatives' Knowledge of Invega Trinza (Survey Data)
        • Psychiatrists' Satisfaction with Sales Representatives' Knowledge of Latuda (Survey Data)
        • Psychiatrists' Satisfaction with Sales Representatives' Knowledge of Rexulti (Survey Data)
        • Psychiatrists' Satisfaction with Sales Representatives' Knowledge of Vraylar (Survey Data)
        • Detailing Messages Encourage Psychiatrists to Prescribe Select Branded Antipsychotics
        • Psychiatrists' Message Recall from Recent Detailing (Survey Data)
    • Methodology
      • Primary Market Research Methodology
      • Distribution of Surveyed Psychiatrists' Primary Practices, by Region (Survey Data)
      • Location of Surveyed Psychiatrists' Primary Practice, by State (Survey Data)
      • Surveyed Psychiatrists' Duration of Clinical Practice (Survey Data)
      • Surveyed Psychiatrists' Type of Clinical Practice (Survey Data)
      • Average Number of Patients with Schizophrenia Whom Psychiatrists Clinically Manage per Month (Survey Data)
      • RWD Methodology
      • Limitations of Comparative Analyses Between Data Sources
    • Appendix
      • Primary Market Research
        • Expanded Product Patient Share by Line of Therapy (Survey Data)
        • Expanded Product Treatment Duration by Line of Therapy (Survey Data)
        • Use of Off-Label Drugs to Treat CIAS (Survey Data)
        • Second-Most-Frequent Antipsychotic from Which Schizophrenia Patients on Select Branded Antipsychotics Were Switched (Survey Data)
        • Third-Most-Frequent Antipsychotic from Which Schizophrenia Patients on Select Branded Antipsychotics Were Switched (Survey Data)
        • Fourth-Most-Frequent Antipsychotic from Which Schizophrenia Patients on Select Branded Antipsychotics Were Switched (Survey Data)
        • Fifth-Most-Frequent Antipsychotic from Which Schizophrenia Patients on Select Branded Antipsychotics Were Switched (Survey Data)
        • Antipsychotics Added to Select Branded Atypical Antipsychotics (Survey Data)
        • Second-Most-Common Antipsychotic Added to Select Branded Antipsychotics (Survey Data)
        • Third-Most-Common Antipsychotic Added to Select Branded Antipsychotics (Survey Data)
        • Fourth-Most-Common Antipsychotic Added to Select Branded Antipsychotics (Survey Data)
        • Fifth-Most-Common Antipsychotic Added to Select Branded Antipsychotics (Survey Data)
        • Second-Most-Common Antipsychotic to Which Schizophrenia Patients Are Switched from Select Branded Antipsychotics (Survey Data)
        • Third-Most-Common Antipsychotic to Which Schizophrenia Patients Are Switched from Select Branded Antipsychotics (Survey Data)
        • Fourth-Most-Common Antipsychotic to Which Schizophrenia Patients Were Switched from Select Branded Antipsychotics (Survey Data)
        • Fifth-Most-Common Antipsychotic to Which Schizophrenia Patients Were Switched from Select Branded Antipsychotics (Survey Data)
        • Factors That Constrain Psychiatrists' Use of Select Branded Oral Atypical Antipsychotics (Survey Data)
        • Factors That Constrain Psychiatrists' Use of Select Branded Atypical Antipsychotic Depots (Survey Data)
      • Real-World Data
        • Gender Distribution Among Patients Diagnosed with Schizophrenia (RWD: EHR)
        • Race Distribution Among Patients Diagnosed with Schizophrenia (RWD: EHR)
        • Body Mass Index Distribution Among Patients Diagnosed with Schizophrenia (RWD: EHR)
        • Patient Share by Product Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Quarter-over-Quarter Patient Share by Product Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Treatment Duration by Product Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Source of Business by Product Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Product Patient Share by Line of Therapy Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Quarter-over-Quarter Product Patient Share by First Line of Therapy Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Quarter-over-Quarter Product Patient Share by Second Line of Therapy Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Quarter-over-Quarter Product Patient Share by Third Line of Therapy Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Combination Therapy by First Line of Therapy Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Combination Therapy by Second Line of Therapy Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Combination Therapy by Third Line of Therapy Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Monotherapy vs. Combination Therapy Use by First Line of Therapy Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Monotherapy vs. Combination Therapy Use by Second Line of Therapy Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Monotherapy vs. Combination Therapy Use by Third Line of Therapy Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Drug Burden Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Compliance by Product Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Ranges of Medication Possession Ratios Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Persistency Sample Sizes Among Drug-Treated Patients Diagnosed with Schizophrenia (RWD: Claims)
        • Comparison of Progression Patterns and Key Therapy Sources Among Schizophrenia Patients (RWD: Claims)
        • Abilify (Oral) Patient Flow in Newly Diagnosed Schizophrenia Patients (RWD: Claims)
        • Abilify (Oral) Patient Flow in Recently Treated Schizophrenia Patients (RWD: Claims)
        • Abilify Maintena (Depot) Patient Flow in Newly Diagnosed Schizophrenia Patients (RWD: Claims)
        • Abilify Maintena (Depot) Patient Flow in Recently Treated Schizophrenia Patients (RWD: Claims)
        • Antiepileptic Drugs Patient Flow in Newly Diagnosed Schizophrenia Patients (RWD: Claims)
        • Antiepileptic Drugs Patient Flow in Recently Treated Schizophrenia Patients (RWD: Claims)
        • Aripiprazole (Oral) Patient Flow in Newly Diagnosed Schizophrenia Patients (RWD: Claims)
        • Aripiprazole (Oral) Patient Flow in Recently Treated Schizophrenia Patients (RWD: Claims)
        • Aristada Patient Flow in Recently Treated Schizophrenia Patients (RWD: Claims)
        • Clozapine Patient Flow in Newly Diagnosed Schizophrenia Patients (RWD: Claims)
        • Clozapine Patient Flow in Recently Treated Schizophrenia Patients (RWD: Claims)
        • Fanapt Patient Flow in Newly Diagnosed Schizophrenia Patients (RWD: Claims)
        • Fanapt Patient Flow in Recently Treated Schizophrenia Patients (RWD: Claims)
        • Haloperidol (Depot) Patient Flow in Newly Diagnosed Schizophrenia Patients (RWD: Claims)
        • Haloperidol (Depot) Patient Flow in Recently Treated Schizophrenia Patients (RWD: Claims)
        • Haloperidol (Oral) Patient Flow in Newly Diagnosed Schizophrenia Patients (RWD: Claims)
        • Haloperidol (Oral) Patient Flow in Recently Treated Schizophrenia Patients (RWD: Claims)
        • Invega Sustenna Patient Flow in Newly Diagnosed Schizophrenia Patients (RWD: Claims)
        • Invega Sustenna Patient Flow in Recently Treated Schizophrenia Patients (RWD: Claims)
        • Invega Trinza Patient Flow in Recently Treated Schizophrenia Patients (RWD: Claims)
        • Latuda Patient Flow in Newly Diagnosed Schizophrenia Patients (RWD: Claims)
        • Latuda Patient Flow in Recently Treated Schizophrenia Patients (RWD: Claims)
        • Olanzapine (Oral) Patient Flow in Newly Diagnosed Schizophrenia Patients (RWD: Claims)
        • Olanzapine (Oral) Patient Flow in Recently Treated Schizophrenia Patients (RWD: Claims)
        • Other Antidepressants Patient Flow in Newly Diagnosed Schizophrenia Patients (RWD: Claims)
        • Other Antidepressants Patient Flow in Recently Treated Schizophrenia Patients (RWD: Claims)
        • Risperdal Consta Patient Flow in Recently Treated Schizophrenia Patients (RWD: Claims)
        • Risperidone (Oral) Patient Flow in Newly Diagnosed Schizophrenia Patients (RWD: Claims)
        • Risperidone (Oral) Patient Flow in Recently Treated Schizophrenia Patients (RWD: Claims)
        • Saphris Patient Flow in Newly Diagnosed Schizophrenia Patients (RWD: Claims)
        • Saphris Patient Flow in Recently Treated Schizophrenia Patients (RWD: Claims)
        • Seroquel XR Patient Flow in Newly Diagnosed Schizophrenia Patients (RWD: Claims)
        • Seroquel XR Patient Flow in Recently Treated Schizophrenia Patients (RWD: Claims)
        • Zyprexa Relprevv Patient Flow in Newly Diagnosed Schizophrenia Patients (RWD: Claims)

Author(s): Lisa Cloonan, BA

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.


Related Reports

Schizophrenia - Landscape & Forecast - Disease Landscape And Forecast G7

The schizophrenia therapy market is very crowded. Many of the antipsychotic therapies are generic, although newer oral atypical antipsychotics (e.g., Intra-Cellular Therapies’ Caplyta) are al...

View Details

Schizophrenia| Disease Landscape and Forecast | G7 | 2020

The schizophrenia therapy market is very crowded. Many of the antipsychotic therapies are generic, although newer oral atypical antipsychotics (e.g., Intra-Cellular Therapies’ Caplyta) are also ava...

View Details

Schizophrenia - Special Topics - Special Topics Evolving Market Dynamics In Schizophrenia US

The schizophrenia therapy market is dominated by oral and long-acting injectable (LAI) antipsychotics, which are primaril...

View Details

Schizophrenia - Special Topics - Special Topics: Agitation In Bipolar And Schizophrenia (US)

Agitation is a common behavioral aspect often associated with bipolar disorder (BPD) and schizophrenia. It often manifests in the form of tension, violence, or...

View Details