Will safety concerns curtail atypicals' growth?

Anyone who keeps pharma's score knows that atypical antipsychotics have grown by leaps and bounds over the past several years. In fact, last year, they were the number one selliing drug class, dollarwise. Partly that's because they're so expensive, but it's also because they've been used more and more broadly--not just for schizophrenia or even bipolar disorder, but for a variety of off-label uses, too.

And now, with Bristol-Myers Squibb's Abilify approved as a depression and anxiety treatment, and AstraZeneca's Seroquel on the verge of getting a similar FDA approval, the class of drugs is poised to grow even more.

The catch is that the drugs have a history of sometimes-severe side effects. As the Los Angeles Times points out in an article today, experts are questioning widespread uptake of the antipsychotics. The FDA advisory panel reviewing Seroquel for depression appeared to concur, saddling their recommendation for approval with a list of safety-related caveats.

Will the safety questions prove to be a drag on antipsychotic sales growth? That remains to be seen. We do know that the industry spent almost $1 billion marketing these drugs back in 2006--and that was before any of them got the OK for depression, a much more common malady than schizophrenia or bipolar.

And that marketing can be very effective. When Bristol started advertising Abilify for depression and anxiety, patients started streaming into one L.A. psychiatrist's office, asking whether they should try the drug. Soon, the same may be true of Seroquel. We'll just have to wait and see.

- see the LA Times story