The unipolar depression market is crowded and highly genericized. The prominent use of selective serotonin reuptake inhibitors (SSRIs) and, to a lesser extent, serotonin / norepinephrine reuptake inhibitors (SNRIs) as early-line treatments contributes to the challenges branded therapies face when entering this market. Newer-to-market brands (e.g., Lundbeck / Takeda’s Trintellix / Brintellix, Lundbeck / Otsuka Pharmaceutical’s Rexulti / Rxulti) largely compete for use in treatment-resistant depression (TRD) patients, who make up one-third of the major depressive disorder population. The most recent entrant into the depression market, Janssen’s Spravato, offers the fastest onset of therapeutic effect among the approved therapies—fulfilling a key unmet need—but its use for TRD is constrained by multiple factors. Because of remaining unmet need, physicians will continue to look to emerging therapies—many of which offer novel mechanisms of action—as potential future treatment options in this market.

QUESTIONS ANSWERED:

  • What factors drive and constrain the use of branded antidepressants and atypical antipsychotics? What branded therapy is expected to experience the greatest commercial success during the forecast period?
  • What clinical role will Spravato (Janssen’s esketamine) play in the treatment of TRD?
  • Given the crowded, highly genericized unipolar depression market, what is the commercial potential of key emerging therapies for unipolar depression?
  • What are the greatest areas of unmet need in the treatment of unipolar depression and how are late-phase emerging therapies expected to address these unmet needs?

Markets covered: United States, France, Germany, Italy, Spain, United Kingdom, Japan

Primary research: Approximately 15 country-specific interviews with thought-leading psychiatrists and PCPs / GPs; supported by survey data collected for this and other DRG research.

Epidemiology: 12-month prevalence of unipolar depression by country, segmented by MDD, minor depression, and dysthymia; diagnosed and drug-treated cases of unipolar depression; 12-month prevalence of MDD by country, segmented by chronic pain status; 12-month prevalence of MDD by country, segmented by treatment-resistant status.

Emerging therapies: Phase III/preregistration: 3 drugs. Coverage of select Phase II and Phase I products.

Market forecast features: 10-year, annualized, drug-level sales and patient share of key unipolar depression therapies from 2019-2029, segmented by brands / generics

Key companies: Allergan, AstraZeneca, Axsome Therapeutics, Biogen, Gedeon Richter, GlaxoSmithKline, Janssen, Lundbeck, Luye Pharma Group, Otsuka Pharmaceutical, Pfizer, Sage Therapeutics, Shionogi, Sumitomo Dainippon, Sunovion, Takeda

Key drugs: Ansofaxine hydrochloride, aripiprazole, bupropion HCl SR/XR, duloxetine, escitalopram, Latuda (lurasidone), quetiapine IR/XR, Rexulti / Rxulti (brexpiprazole), Spravato (esketamine), Trintellix / Brintellix (vortioxetine), venlafaxine IR / XR, Vraylar / Reagila (cariprazine), AXS-05, zuranolone (SAGE-217)

Table of contents

  • Unipolar Depression - Landscape & Forecast - Disease Landscape & Forecast

Author(s): Joyce Spadafora, A.L.M.; Arava Suresh, M.Pharm.; Audreza Das, P.G. Dip. ; Shilpa Thakur

Joyce Spadafora, A.L.M., is a senior analyst on the CNS/Ophthalmology Disorders team at DRG, part of Clarivate. She authors content on various chronic pain and psychiatric indications. Prior to joining DRG, she spent several years in the biotech industry focusing on new product development and consulting. She holds a master’s degree in extension studies in psychology from Harvard University and a B.S. in mechanical engineering from the Massachusetts Institute of Technology.

Arava Suresh, M.Pharm., is a research associate on the CNS/Ophthalmology Disorders team at DRG, part of Clarivate. He earned a master’s degree in pharmaceutical administration and management from Manipal University in India.

Audreza Das, P.G. Dip., B.E., is a senior analyst on the CNS/Ophthalmology Disorders team at DRG, part of Clarivate. She has authored content on neuropathic pain, age-related macular degeneration, attention-deficit/hyperactivity disorder, unipolar depression, bipolar disorder, treatment-related depression, postherpetic neuralgia, painful diabetic neuropathy, and migraine. Ms. Das obtained her P.G. Dip. in cancer immunology and biotechnology from the University of Nottingham and a B.E. in biotechnology from the Birla Institute of Technology.

Shilpa Thakur, M.P.H., is an associate epidemiologist at DRG, part of Clarivate. Before joining DRG, she monitored HIV sentinel surveillance in Himachal Pradesh. She has also studied the patterns of antimicrobial resistance in India. She received her M.P.H. from the Postgraduate Institute of Medical Education and Research with a specialization in epidemiology and biostatistics.


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