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Major Depressive Disorder
Major depressive disorder (MDD) is a serious condition that can affect patients’ ability to sleep, work, eat, and go about their lives.1 This extremely complex disease is poorly under stood and is thought to be caused by both genetic and environmental factors. Its development is associated with numerous neurotransmitter abnormalities, including serotonin, norepinephrine, and dopamine, among others.2
The disease is fairly common today, with a prevalence of approximately 32 million patients globally in 2013; only 12 million of those patients were actively seeking treatment.2
Despite its serious signs and symptoms, MDD can be improved dramatically through pharmacological intervention. MDD treatment has created a saturated market, with medications targeting numerous mechanisms of action, and this market is expected to grow more crowded in the coming years.4 In 2013, drug sales yielded $9.3 billion globally, with the U.S. accounting for $7.5 billion; this is expected to reach $9.7 billion globally and $7.6 billion in the U.S. by 2023.3
The MDD market of the future will be filled with new therapies targeting key unmet needs, such as increased efficacy, a safer profile, and a faster onset of action. Manufacturers hope to use novel mechanisms of action to improve drug profiles and help patients to better manage this disease.3
||NDA filed||Up to 3 mg/day orally||NCT01360645
|Q2 2015||Brexpiprazole will likely be priced similarly to Abilify; US sales $529 million by 2023|
||NDA filed||Up to 4.5 mg/day orally||NCT01838876
|Q2 2015||Cariprazine will likely be priced similarly to Abilify and Seroquel XR; US sales $322 million by 2023|
||Phase 3||Up to 2 mg/day orally||FORWARD program||2017||ALKS-5461 will likely be priced approximately 10% higher than Abilify and Seroquel XR; US sales $1.23 billion by 2023|
||Phase 3||Up to 100 mg/day orally (efficacy dose yet to be determined)||TRIADE program||2018||Amitifadine will likely be priced similarly to branded SNRIs; US sales $493 million by 2023|
||Phase 3||Up to 10 mg/kg intravenously (frequency unknown)||NCT01684163||2018||GLYX-13 will likely be priced 20%–30% higher than other adjunctive treatments; US sales $227 million by 2023|
||Phase 2b||10 mg/day or 20 mg/day orally||NCT00599911||2018||Tedatioxetine will likely be priced similarly to Brintellix; US sales $335 million by 2023|
||Phase 2b||20 mg/day (low dose) or 70 mg/day (high dose) orally||NCT02014363||2020||ETS6103 will likely be priced similarly to branded second-line treatments; US sales $66 million by 2023|
NDA = new drug application; Q2 = quarter two; SNRIs = serotonin–norepinephrine reuptake inhibitors; US = United States
Sources: FDA; GlobalData; company websites;
||September 30, 2013||Treatment of MDD||20 mg daily orally||$3,499|
||January 21, 2011||Treatment of MDD||40 mg daily orally||$2,767|
||August 14, 2002||Acute and maintenance treatment of MDD in adults and adolescents ages 12–17 years||10 mg daily orally||$2,942 (generic, $1,554)|
||July 17, 1998||Treatment of MDD||20 mg daily orally||$2,535 (generic, $50)|
||December 29, 1992||Treatment of MDD||20 mg daily orally||$2,184 (generic, $964)|
||December 30, 1991||Treatment of MDD||50 mg daily orally||$2,743 (generic, $986)|
||December 29, 1987||Acute and maintenance treatment of MDD||20 mg daily orally||$3,916 (generic, $18)|
||July 25, 2013||Treatment of MDD||40 mg to 120 mg daily orally||$3,456|
||February 29, 2008||Treatment of MDD||50 mg daily orally||$3,381|
||August 3, 2004||Treatment of MDD||60 mg daily orally||$3,184 (generic, $730)|
||December 28, 1993||Treatment of MDD||75 mg daily orally||Generic, $798|
||December 30, 1985||Treatment of MDD||200 mg daily orally||$2,590 (generic, $350)|
||June 14, 1996||Treatment of MDD||15 mg daily orally||$2,185 (generic, $117)|
||February 27, 2006||MDD||6 mg per 24 hours via transdermal system||$17,498|
||June 9, 1961||Treatment of atypical, nonendogenous, or neurotic depression||15 mg three times a day orally||$1,872 (generic, $914)|
||February 21, 1961||Treatment of MDD, involutional melancholia, reactive depression, and psychoneurotic depression of moderate to severe intensity||20 mg daily orally||$5,160 (generic, $2,365)|
||July 1, 1959||Treatment of MDD||10 mg two times a day orally||$3,451|
||May 22, 1984||MDD, childhood enuresis||50 mg to 150 mg daily orally||$3,979–$11,937 (generic, $422–$1,267)|
||September 22, 1980||Treatment of neurotic, reactive, endogenous, and psychotic depression||200 mg to 300 mg daily orally||Generic, $1,086–$1,629|
||June 12, 1979||MDD||75 mg to 300 mg daily orally||$4,376–$11,482|
||August 1, 1977||MDD||75 mg to 100 mg daily orally||$14,077–$27,623 (generic, $104–$150)|
||September 27, 1967||MDD||20 mg to 60 mg daily orally||Generic, $1,927–$5,782|
||November 20, 1964||Treatment of depression||100 mg to 200 mg daily orally||$2,562–$5,125 (generic, $1,551–$3,102)|
||April 7, 1961||MDD||75 mg daily orally||Generic, $391|
aThis list is not all-inclusive; additional therapies may be available for this disease state.
bAbbreviated indication provided; for full indication, please refer to prescribing information.
cRegimens based on the recommended dosage and maintenance phases from prescribing information; typical doses and titration schedules may vary based on patient-specific requirements.
dCosts calculated using average wholesale price and regimen provided and rounded to the nearest dollar.
eThe brand-name version of this medication has been discontinued.
Sources: Red Book; Drugs@FDA; and prescribing information for all medications
MDD = major depressive disorder
- National Institute of Mental Health Depression. Available at: https://www.nimh.nih.gov/health/topics/depression/index.shtml. Accessed January 18, 2015.
- WebMD. Causes of depression. February 2014;Available at: https://www.webmd.com/depression/guide/causes-depression. Accessed January 18, 2015.
GlobalData. Major Depressive Disorder—Global Drug Forecast and Market Analysis to 2023 May 2014;
- DiPiro J, Talbert RL, Yee G, et al. Major depressive disorder. Pharmacotherapy: A Pathophysiologic Approach
9th edNew York, New York: McGraw-Hill. 2014;1047–1066.