Add-on depression meds a bright spot in eroding market

The market for depression drugs is in the middle of a major upheaval that's set to siphon off $2 billion in sales by 2020, a Decision Resources report concludes. Generic rivals for top-selling brands from Forest Laboratories ($FRX) and Eli Lilly ($LLY) will account for much of that decline, but ongoing erosion of Pfizer's ($PFE) Effexor XR sales, which lost patent protection last year, will also contribute.

Plus, most potential new treatments for unipolar depression don't look as if they'll deliver huge clinical improvements, meaning they're likely to be relegated to at least second-line treatment, Decision Resources says. First-line treatment will largely depend on cheaper, off-patent meds.

Revenues in 7 top antidepressant markets amounted to $11.6 billion in 2010, but a decade later, they're expected to stand at $9.8 billion. One reason why sales aren't expected to drop further is that depression drugs deliver relatively low response rates. After first-line treatment fails--which it does in about one-third of depression patients--doctors may turn to newer branded drugs.

Indeed, the atypical antipsychotic drugs Abilify (Bristol-Myers Squibb and Otsuka) and Seroquel (AstraZeneca) are gaining patient share as add-on treatments for major depression, the report points out. And one exception to the weakness of pipeline treatments is AZ's TC-5214, which could carry fewer side effects than other add-on meds, the report says.

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