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TMO Overview - Depression

Depression is a disease caused by chemical imbalances in the brain which may take on many different forms; however, depression also results from environmental factors. The etiology of depression is largely unknown, which complicates clinical practice, drug R&D, and therapy selection. Despite the fact that depression is considered to be a mature market, AVOS predicts that the theoretical population of people suffering from some type of depression or anxiety disorder will increase from 46.7 million in 2008 to 49.3 million in 2013; and the addressable, or diagnosed portion of that population, will grow from 25.6 million to 27 million over the same time period. This growth is not reflected in the market, however, as generic substitution is expected to drive an estimated market decline from $14.3 million in 2008 (with contributions from blockbuster products such as Lexapro and Cymbalta, as well as from the Effexor franchise) to $12.6 million in 2013 (with contributions from only one blockbuster product, Cymbalta). Compounds with novel mechanisms of action (e.g., NK antagonists and β3-adrenoceptor agonists) will launch in the outer years of our forecast, but will be too late to counteract this market contraction.

AVOS Life Sciences' TMO Depression report addresses each key aspect of a rigorous, disease-based market analysis:

Market Size & Expected Growth	In-depth epidemiological analysis and modeling Detailed review of current and projected treatment landscape at a class level
Treatment Cascade	Consideration of the treatment algorithms for primary indication Impact of manipulating treatment cascade through promotional and other initiatives
Drug Class Characteristics	Fundamentals: safety, efficacy, side effects, onset of action, duration, etc. Developer strengths and weaknesses (technology, marketing, sales, etc.)
Competitive Landscape	Comprehensive competitve pipeline overview at a drug level In-depth review of all major competing treatment mechanisms and drug classes
Pricing & Reimbursement Landscape	Where appropriate, price elaticity calculations based on payer and provider interviews Evaluation of reimbursement landscape for indication and similar projects
Class Position Effects	Detailed research and analysis for first-in-class products Scenario analysis of entrants into markets with existing products
Projected Market Share Shifts	Sophisticated uptake models (historical view, firm and product attributes) Predictions for shifts resulting from the use of several marketing levers

Key findings in AVOS's TMO Depression report include:

• Generic dominance will slow top line revenue growth in the maturing antidepressant market: The traditional antidepressant market is beyond its growth stages, with increasing generic availability entering the market throughout our forecast period. We expect the market to...
• Migrating commercial strategies for growth will lead to new sources of competition: In a mature market environment, branded manufacturers are proactively changing the basis of competition to address not only the core aspects of depression but...
• Effectiveness of sampling and personal promotion has been proven and continues to be strong in this market: Due to the inability to predict patient response, physicians are likely to start Rx drug therapy via a sample to test for potential therapy success in individual patients. Particularly as all in-line products forecasted in our model are...
• The ability to leverage a strategic contracting approach within this market will be limited: As a CNS disease, the prevailing formulary environment for depression stresses multiple drug options within a formulary tier. As part of efforts to more actively manage the Rx drug benefit for depression therapies going forward, we anticipate...
• Side effect rather than efficacy advances are anticipated for new mechanisms of action: Limited by clinical trial design where comparative efficacy trials are not typically conducted, the AVOS Physician Panel suggests that...
• Wyeth's Pristiq is expected to fall short of expectations: Wyeth's strategy to market Pristiq as a lifecycle management product to the Effexor franchise appears to be flawed...

TMO Depression delivers distinct value to individuals in all roles across the pharmaceutical and biotechnology industries who are looking for fresh angles of opportunity in this maturing market environment.