Numerous antidepressant therapies are available to treat major depressive disorder (MDD), many of which have long been generic and are entrenched in medical practice. However, most current therapies suffer from shortcomings in efficacy and/or safety and tolerability, resulting in inadequate patient response and remission rates and creating opportunities for new, improved therapies for treatment-resistant depression (TRD). Although newer-to-market agents such as Lundbeck / Takeda’s Trintellix / Brintellix (vortioxetine) and Janssen’s Spravato (esketamine) have expanded the armamentarium of therapeutic options and, in the case of Spravato, provided a novel, fast-acting option, unmet need remains for new therapies. This report provides quantitative insight into psychiatrists’ perceptions of key treatment drivers and goals and assesses the current level of unmet need and opportunity in the treatment of TRD.


  • What are the treatment drivers and goals for TRD?
  • What are surveyed psychiatrists’ opinions of the relative performance of select therapies, including Trintellix / Brintellix (Lundbeck / Takeda), Spravato (Janssen), and aripiprazole (Otsuka Pharmaceutical’s Abilify, generics) on key efficacy, safety / tolerability, and convenience of administration attributes?
  • What drug attributes are key influencers, which have limited impact, and which are hidden opportunities?
  • What trade-offs across different clinical attributes and prices are acceptable to U.S. and European psychiatrists for a hypothetical new drug to treat TRD?


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. One market scenario is profiled in detail by DRG experts, and additional customized market scenarios can be evaluated with the corresponding TPP simulator.

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

Primary research: Survey of 60 U.S. and 30 European psychiatrists fielded in May 2020.

Key companies: AstraZeneca, Eli Lilly, Janssen, Lundbeck, Otsuka Pharmaceutical, Takeda Pharmaceuticals

Key drugs: Aripiprazole, bupropion SR, duloxetine, quetiapine XR, Rexulti, Spravato, Trintellix / Brintellix

Key metrics provided:

  • 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.
  • Analysis of remaining drug development opportunities.

Table of contents

  • Unipolar Depression - Unmet Need - Detailed, Expanded Analysis - Treatment-Resistant Depression (US & EU) - 2020

Author(s): Thomas Cronin

Since joining DRG in late 2019, Tom has worked on reports focusing on psychiatric and ophthalmologic disorders for the CNS team. His background is in biochemistry and he previously worked in the intellectual property field as a registered Patent Agent. Prior to joining DRG, Tom was an Intellectual Property Manager in a Boston-based biopharmaceutical company focusing on treating metabolic diseases and disorders. He has also worked for several internationally recognized law firms representing corporate and institutional clients in all matters of life science – related intellectual property.

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