Commercial Insight: Antidepressants - Sliding SSRI Revenues Inevitable

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Publication Date: 2004-02-06

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Introduction
The global antidepressant market has seen extraordinary growth over the last decade. However, with few entrants, and a flood of patent expiries by 2009, the dynamics of this $16.9 billion market are set to undergo a major change. As generic competition intensifies, companies need to carefully re-examine their strategies if they wish to protect their market share.

Scope

In-depth profiles of current market-leading brands, including major event impacting each brand during 2002-2003
Analysis of potential strategies to help maximize and protect revenues
Global sales for leading antidepressants in 2001 and 2002, with projections for future performance to 2011

Highlights
Antidepressant sales are expected to decrease by -21.5% to $13.5 billion by 2011. During the forecast period, 2003-11, the market will experience a period of high volatility as revenues are impacted by consecutive patent expiries and limited product launches.

The serotonergic class dominates the market, accounting for 57.6% of market share in 2002. However, all of the leading brands will suffer patent expiries by 2009. As physicians are encouraged to utilize cheaper generics, brand players must look towards maximizing revenues through product differentiation and innovative lifecycle strategies.

Wyeth's noradrenergic, Effexor has positioned itself as a relatively unique product in the antidepressant market. However, with Lilly's Cymbalta demonstrating a similar mode of action and anticipated to launch in mid 2004, Effexor is expected to undergo its first major challenge to its market position.

Why you should buy this report

Assess leading antidepressants and identify key success factors within this sector
Understand key market drivers and predict the future performance of key compounds
Benchmark pipeline antidepressants against currently marketed products and assess their future market potential

CHAPTER 1 EXECUTIVE SUMMARY - page 3
- Scope of the analysis - page 3
- Datamonitor insight into the antidepressant market - page 4
  - The antidepressant market is set to undergo a period of rapid change as seven out of the eight leading brands suffer US patent expiries by 2008. With only a handful of new products anticipated to replace these blockbuster products, the market is expected to decrease by -21.5% to $13.5 billion by 2011, as physicians are encouraged to utilize cheaper generics. Brand players must look towards maximizing revenues through product differentiation and innovative lifecycle strategies. - page 5
  - Forest's Lexapro is the only marketed antidepressant expected to achieve a positive CAGR over the full forecast period, 2003-11. Nonetheless, success is reliant on the company's ability to switch patients from Lexapro's predecessor, Celexa by convincing physicians of the resulting clinical benefits. The key drivers to initiating this switch are to clearly differentiate the two products and to present Lexapro as a more complete compound. - page 6
  - Wyeth's noradrenergic, Effexor has positioned itself as a relatively unique product in the antidepressant market. However, with Lilly's Cymbalta demonstrating a similar mode of action and anticipated to launch in mid 2004, Effexor is expected to undergo its first major challenge to its market position. Effexor must consolidate its position by gaining new indications in areas such as neuropathic pain and moving the focus to primary care. - page 7
  - Summary - page 9
- Key metrics - page 9
- Key market events during 2002/2003 - page 10
  - Regulators warn about use of antidepressants in pediatrics - page 10
  - Paxil generics launched in the US - page 11
  - Lilly announces expected launch of Cymbalta - page 11
TABLE OF CONTENTS - page 12
CHAPTER 2 MARKET SEGMENTATION & DEFINITION - page 20
- Strategic scoping and focus - page 20
  - Poor diagnosis and treatment - page 20
  - Concerns over safety - page 21
  - Limited improvements and new chemical entities - page 23
  - Lifecycle strategies - page 24
- Market definition - page 25
- The gold standard in major depressive disorder - page 26
- Associated pharmaceutical markets and indications - page 28
  - Depression and anxiety - page 28
  - Depression and novel non-anxiety indications - page 29
CHAPTER 3 GLOBAL MARKET OVERVIEW - page 30
- Key findings - page 30
- Global antidepressant market analysis - page 31
  - Global market forecast - page 33
- Serotonergic class analysis - page 34
  - Serotonergic market performance - page 34
  - Serotonergic value and volume analysis - page 35
  - Serotonergic market forecast - page 36
  - R&D drugs in the serotonergic class - page 38
  - Prozac analysis - page 39
  - Paxil analysis - page 47
  - Zoloft analysis - page 54
  - Celexa analysis - page 62
  - Lexapro analysis - page 67
  - Other recent events in the serotonergic market - page 74
- Noradrenergic class analysis - page 80
  - Noradrenergic market performance - page 80
  - Noradrenergic market forecast - page 82
  - R&D drugs in the noradrenergic class - page 83
  - Effexor analysis - page 84
  - Remeron analysis - page 91
- Novel compound class analysis - page 96
  - Novel compound market performance - page 96
  - Novel compound market forecast - page 97
  - R&D drugs in the novel compound class - page 98
  - Wellbutrin analysis - page 100
CHAPTER 4 PORTFOLIO AND LIFECYCLE MANAGEMENT - page 107
- Key findings - page 107
- Portfolio management - page 108
  - Market attractiveness - page 108
  - Positioning of the major antidepressant players - page 111
  - Portfolio analysis - page 114
- Lifecycle management of antidepressants - page 125
  - The antidepressant product lifecycle - page 125
  - Launch strategy and market penetration - page 126
  - Optimizing peak sales - page 130
  - Revenue protection strategies - page 132
CHAPTER 5 STRATEGIC PRODUCT POSITIONING - page 134
- Key findings - page 134
- Physician-focused product positioning - page 135
  - Brand positioning for key products in the major markets - page 138
  - Benchmarks and case studies - page 140
- Pharmacist role - page 141
- Patient targeting and influence - page 141
  - Patient sub-group positioning analysis - page 141
  - DTC advertising - page 143
- Brand imaging - page 144
  - Product specific websites - page 144
  - Company health information websites - page 148
  - Company activity with patient advocacy groups - page 149
  - Patient education initiatives - page 151
- Pricing and reimbursement - page 152
  - US - page 152
  - EU - page 152
  - Health economic considerations - page 153
  - Pricing strategies - page 153
- Global antidepressant market data - page 155
- Serotonergic market data - page 156
- Noradrenergic market data - page 158
- Novel compound market data - page 159
- List of tables - page 160
- List of figures - page 162
- Bibliography - page 163
  - Market segmentation and definition - page 163
  - Global market overview - page 164
  - Strategic product positioning - page 167
  - National Formularies - page 168
- Websites - page 169
- Report methodology - page 170
  - Date of research completion - page 170
- About Datamonitor - page 171
  - About Datamonitor Healthcare - page 171
  - Datamonitor Healthcare's research and analysis methodologies - page 172
- Datamonitor Healthcare's therapy area capabilities - page 172
  - About the CNS analysis team - page 173
  - Datamonitor Healthcare's Consulting expertise - page 174
  - Key therapy team members - page 175
  - Disclaimer - page 177

List of Tables
Table 1: Key parameters of the antidepressant market to 2011 - page 9
Table 2: Forecast for key currently marketed antidepressant products, 2003-11 - page 10
Table 3: Defining the gold standard: key clinical trial results for fluoxetine - page 27
Figure 3: Comparative class contribution to antidepressant market growth by quarter, 2001-02 - page 32
Figure 4: Global antidepressant market forecast, 2003-11 - page 33
Table 4: Global antidepressant market forecast, 2003-11 - page 33
Table 5: Global sales of leading serotonergics ($m), 1997-2002 - page 34
Figure 5: Relative sales performance of top four serotonergics ($m), 2001-02 - page 35
Figure 6: Serotonergic value/volume analysis, 2001-02 - page 36
Figure 7: Serotonergic market concentration, 2003-11 - page 37
Table 6: Global serotonergic forecast by leading brand, 2003-11 - page 37
Table 7: R&D included in the serotonergic class forecast, 2003-11 - page 38
Table 8: Prozac: key facts - page 39
Table 9: Key fluoxetine events, 2002-03 - page 40
Table 10: Paxil: key facts - page 47
Table 11: Key paroxetine events, 2003 - page 48
Table 12: Key paroxetine events, 2002 - page 49
Table 13: Zoloft: key facts - page 54
Table 14: Key sertraline events, 2002-03 - page 55
Table 15: Celexa: key facts - page 62
Table 16: Key citalopram events, 2002-03 - page 63
Table 17: Lexapro: key facts - page 67
Table 18: Key escitalopram events, 2003 - page 68
Table 19: Key escitalopram events, 2002 - page 69
Table 20: Serzone: key facts - page 75
Table 21: Key nefazodone events, 2002-03 - page 76
Table 22: Luvox: key facts - page 78
Table 23: Key fluvoxamine events, 2002-03 - page 79
Table 24: Global sales of leading noradrenergics ($m), 1997-2002 - page 80
Figure 18: Noradrenergic contribution to market growth by quarter, 2001-02 - page 81
Figure 19: Noradrenergic market concentration, 2003-11 - page 82
Table 25: Global noradrenergic forecast by leading brand, 2003-11 - page 82
Table 26: R&D included in the noradrenergic class forecast, 2003-11 - page 83
Table 27: Effexor: key facts - page 84
Table 28: Effexor events, 2002-03 - page 85
Table 29: Remeron: key facts - page 91
Table 30: Mirtazapine events, 2002-03 - page 92
Table 31: Global sales of leading novel compounds ($m), 1997-2002 - page 97
Figure 24: Novel compound market concentration, 2003-11 - page 97
Table 32: Global novel compound forecast by leading brand, 2003-11 - page 98
Table 33: R&D included in the noradrenergic class forecast, 2003-11 - page 98
Table 34: Wellbutrin: key facts - page 100
Table 35: Key bupropion events, 2002-03 - page 101
Table 36: Total, CNS and antidepressant performance of the antidepressant market leaders, 2002 - page 111
Table 37: Growth in total ethical, CNS and antidepressant revenues for the antidepressant market leaders, 2001-02 - page 112
Table 38: Antidepressant market leader key drug group portfolio composition, 2002 - page 114
Table 39: Overview of antidepressant pipeline and marketed drugs of key players - page 115
Table 40: GSK marketed antidepressant products, 2001-2002 - page 115
Table 41: Pfizer marketed antidepressant product, 2001-2002 - page 117
Table 42: Wyeth marketed antidepressant product, 2001-2002 - page 118
Table 43: Forest marketed antidepressant products, 2001-2002 - page 119
Table 44: Lundbeck's marketed antidepressant products, 2001-2002 - page 120
Table 45: Organon's marketed antidepressant product, 2001-2002 - page 121
Table 46: Lilly marketed antidepressant product, 2001-2002 - page 122
Table 47: BMS's marketed antidepressant products, 2001-2002 - page 123
Table 48: Solvay's marketed antidepressant products, 2001-2002 - page 124
Table 49: Key themes pursued by major antidepressant companies at main psychiatric conferences, 2003 - page 138
Table 50: Selected market pricing data for antidepressants, 2003 - page 154
Table 51: Global sales in the antidepressant market by drug class, 2001-02 - page 155
Table 52: Serotonergic fact file - page 156
Table 53: Global sales of the leading branded serotonergic drugs, 2001-02 - page 157
Table 54: Noradrenergic fact file - page 158
Table 55: Global sales of the leading branded noradrenergic drugs, 2001-02 - page 158
Table 56: Novel compound fact file - page 159
Table 57: Global sales of the leading branded novel compound drugs, 2001-02 - page 159

List of Figures
Figure 1: Key drivers of the antidepressant market to 2011 - page 9
Figure 2: Development of the antidepressant drug classes and leading drugs within each class , 1950-2003. - page 31
Figure 8: SWOT analysis for Prozac - page 41
Figure 9: Global sales forecasts for Prozac, 2003-11 - page 44
Figure 10: SWOT analysis for Paxil - page 50
Figure 11: Global sales forecasts for Paxil, 2003-11 - page 52
Figure 12: SWOT analysis for Zoloft - page 56
Figure 13: Global sales forecasts for Zoloft, 2003-11 - page 59
Figure 14: SWOT analysis for Celexa - page 64
Figure 15: Global sales forecasts for Celexa, 2003-11 - page 65
Figure 16: SWOT analysis for Lexapro - page 70
Figure 17: Global sales forecasts for Lexapro, 2003-11 - page 72
Figure 20: SWOT analysis for Effexor - page 86
Figure 21: Global sales forecasts for Effexor, 2003-11 - page 89
Figure 22: SWOT analysis for Remeron - page 93
Figure 23: Global sales forecasts for Remeron, 2003-11 - page 95
Figure 25: SWOT analysis for Wellbutrin - page 102
Figure 26: Global sales forecasts for Wellbutrin, 2003-11 - page 104
Figure 27: Competitive attractiveness of the antidepressant market, 2002-11 - page 108
Figure 28: Comparative attractiveness of the serotonergic class versus noradrenergic class, 2002-11 - page 110
Figure 29: Positioning of the antidepressant market leader portfolios, 2001-02 - page 113
Figure 30: Global sales of Prozac, 1992-2002 - page 125
Figure 31: MDD diagnosing medical professional, 2002 - page 135
Figure 32: Effexor website information for health care professionals - page 140
Figure 33: Prozac patient product positioning - page 146
Figure 34: Paxil website - page 148
Figure 35: Pfizer's health information website - page 149
Figure 36: National Phobics Society website, sponsored by GSK - page 151
Figure 37: Datamonitor's Healthcare Consultancy - page 174
Figure 38: Datamonitor Healthcare's Therapeutic Consulting capabilities - page 175

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Commercial Insight: Antidepressants - Sliding SSRI Revenues Inevitable

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