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Pipeline and Commercial Insight: Schizophrenia - Second Generation Depots Protect Market Value
Datamonitor, Oct 2008, Pages: 277
CHAPTER 1 EXECUTIVE SUMMARY Scope of the analysis 3 Insight into the schizophrenia market 3 Contributing experts 6 Related reports 7 Upcoming reports 8
CHAPTER 2 PATIENT POTENTIAL Definition of schizophrenia 11 Classification of schizophrenia 11 DSM-IV defined symptoms of schizophrenia 12 A - Characteristic symptoms 12 B - Social/occupational dysfunction 13 C - Duration 13 D - Schizoaffective and mood disorder exclusion 13 E - Substance/general medical condition exclusion 13 F - Relationship to a pervasive developmental disorder 14 Characterization of symptoms 14 Array of symptoms characterize the disorder 14 Symptoms subdivided into positive and negative 14 Ongoing discussion of symptom categories 14 Epidemiology of schizophrenia 16 Schizophrenia affects approximately 0.6% of the population 16 Etiology and course of schizophrenia 18 Age of onset 18 Risk factors 19 Co-morbidities of schizophrenia 19 Anxiety is the most prevalent co-morbidity of schizophrenia 21 Unmet needs in schizophrenia 21 Improving patient compliance 22 Innovative solutions for partial responders or refractory patients 24 Improving cognitive functioning 26 Treating negative symptoms 26 Reducing adverse events 27
CHAPTER 3 MARKET OVERVIEW Seven major markets 30 Current market assessment 30 Sales revenue is dominated by atypical antipsychotics 30 Typical antipsychotics still constitute a significant share of the total volume of antipsychotic prescriptions 31 Comparison between regions 32 Future market assessment 36 Market value stagnation expected over forecast period 36 Genericization becomes a major issue in the schizophrenia market 37 Market value is sustained through uptake of depot atypicals 37 Opportunities and threats 42 Opportunities 42 Threats 43
CHAPTER 4 BRAND DYNAMICS Overview of competitive landscape 49 Lack of gold standard antipsychotic 49 Leading brands and their evolution 49 Impact of generics on the current leading companies 50 Oral pipeline drugs offer limited competition for the current market leaders 51 Drivers of brand choice 53 Zyprexa 55 Zypadhera: olanzapine depot in pre-registration 56 Drug profile 56 Product positioning 57 Marketing mix 58 Brand forecast to 2017 59 Zyprexa: market leader over the last 4 years 2004-07 59 Zyprexas sales widely reduced by market genericization from 2008 59 Zyprexas sales affected by pipeline drug launch 60 Strategic recommendations 61 Risperdal 62 Drug profile 63 Product positioning 63 Marketing mix 64 Brand forecast to 2017 65 Risperdal second leading brand in 2007 65 Risperdal Oral widely affected by risperidone generics 66 Strategic recommendations 68 Risperdal Consta 68 Drug profile 71 Product positioning 72 Marketing mix 72 Brand forecast to 2017 74 Historical trends and geographic expansion 74 Risperdal Consta sales widely impacted by second generation depots 74 Risperdal Consta generics 75 Strategic recommendations 76 Abilify 77 Drug profile 77 Product positioning 78 Marketing mix 80 Brand forecast to 2017 81 Strong Abilify sales growth from 2004 to 2007 81 Abilify forecast sales revenue benefits from a late genericization 82 Strategic recommendations 83 Seroquel 84 Drug profile 85 Product positioning 85 Marketing mix 86 Brand forecast to 2017 88 Seroquel XR likely to relieve Seroquel in schizophrenia treatment 88 Quetiapine generics are expected to threaten both version sales 88 Strategic recommendations 90 Geodon 90 Drug profile 91 Product positioning 92 Marketing mix 94 Brand forecast to 2017 95 Geodons moderate success over the past 4 years will continue until 2012 95 Ziprasidone generics arrival in 2012: the major event likely to impact Geodons sales revenue 95 Strategic recommendations 97 Invega 97 Drug profile 98 Product positioning 99 Marketing mix 100 Brand forecast to 2017 101 Strategic recommendations 103 Other recently launched atypical antipsychotics 104 Serdolect 104 Serdolect history 105 Brand forecast to 2017 106 Lonasen 106 Brand forecast to 2017 107
CHAPTER 5 PIPELINE OVERVIEW AND CLASSIFICATION Pipeline overview 110 Classification of pipeline products 115 Serotonergic and dopaminergic receptor antipsychotics 115 Others 116 Glutamate (AMPA and NMDA) and glycine receptor modulators 116 Muscarinic M1 receptor agonist 116 Alpha 2 adrenoceptor antagonist 116 Nicotinic acetylcholine receptor modulators 117
CHAPTER 6 LATE STAGE DRUG ANALYSIS AND FORECASTS Key late stage pipeline summary 119 Comparative forecasts 119 Comparative drug assessment 119 Definition of current comparator therapy 120 Zyprexa: leading brand on the schizophrenia market 120 Drugs in pre-registration 122 Zypadhera (olanzapine depot) 122 Drug overview 122 Forecasts to 2017 123 Datamonitor drug assessment summary 126 Marketing factors 126 Patient potential 127 Satisfaction of unmet needs 130 Clinical trial data 132 Paliperidone palmitate depot 135 Drug overview 135 Forecasts to 2017 135 Datamonitor drug assessment summary 138 Marketing factors 139 Patient potential 142 Satisfaction of unmet needs 143 Clinical trial data 144 Asenapine 149 Drug overview 149 Forecasts to 2017 150 Datamonitor drug assessment summary 152 Marketing factors 153 Patient potential 154 Satisfaction of unmet needs 155 Clinical trial data 157 Drugs in Phase III clinical trial 164 Bifeprunox 164 Drug overview 164 Forecasts to 2017 166 Marketing factors 168 Patient potential 169 Satisfaction of unmet needs 170 Clinical trial data 171 Lurasidone 176 Drug overview 176 Forecasts to 2017 177 Datamonitor drug assessment summary 179 Marketing factors 179 Patient potential 180 Satisfaction of unmet needs 181 Clinical trial data 182 Staccato loxapine (AZ-004) 189 Drug overview 189 Forecasts to 2017 190 Datamonitor drug assessment summary 192 Marketing factors 192 Patient potential 193 Satisfaction of unmet needs 195 Clinical trial data 197 Drugs in Phase II clinical trial 201 LY-2140023 201 Drug overview 201 Forecast to 2017 201 Datamonitor drug assessment 202 Marketing factor 203 Patient potential 204 Satisfaction of unmet needs 204 Clinical trial data 205 Unforecasted late-stage drug 207 Iloperidone 207 Drug overview 207 Forecasts to 2017 209 Marketing factors 210 Patient potential 210 Satisfaction of unmet needs 211 Clinical trial data for iloperidone oral 211 Clinical trial data for iloperidone depot 216 Other unforecasted drugs 217 Pimavanserin tartrate (ACP-103) 217 Drug overview 217 Clinical trial data 218 BL-1020 221 Drug overview 221 Clinical trial data 222 RGH-188 cariprazine 226 Drug overview 226 Clinical trial data 227 Erythropoietin - NTx-028 230 Drug overview 230 Clinical trial data 230 SAM-101 232 Drug overview 232 Clinical trial data 232 Preclinical study comparing minocycline and haloperidol 234 Sabcomeline 234 Drug overview 234 PF-02545920 235 Drug overview 235 Clinical trial data 235 PNB-02 237 Drug overview 237
BIBLIOGRAPHY Journal papers, books, and conference abstracts 238 Websites 247 Annual reports 254
APPENDIX A - MARKET ASSUMPTIONS New product launches 256 Patent expiries 256 Data definitions, limitations and assumptions 258 Standard units 258 Japanese market data 258 Derivation of sales forecasts and pricing trends 258 Indication-specific sales methodology 259 Schizophrenia-specific sales calculations 259 ICD-10 codes used to define current schizophrenia market 259 Diagnosis values for key brands 260 Drug assessment summary 260 Forecast methodology 262
APPENDIX B Contributing experts 263 About the Disease analysis team 265 Disclaimer 266
List of Tables Table 1: Diagnostic criteria for schizophrenia and its subtypes 11 Table 2: Prevalence studies of schizophrenia 17 Table 3: Prevalence of schizophrenia in the seven major markets, 2008 18 Table 4: Prevalence of patients with schizophrenia exhibiting co-morbid psychiatric disorders across the US, EU and Japan (%), 2005 20 Figure 3: Unmet needs in schizophrenia, 2008 22 Table 5: Sales forecasts for schizophrenia market in the seven major markets ($m), 2007-2017 39 Table 6: Key branded atypical antipsychotics patents expiry dates across the US, the 5EU and Japan (1/2) 44 Table 7: Summary of opportunities and threats in the schizophrenia market across the seven major markets, 2008 47 Table 8: Leading branded drug sales revenue ($m) for schizophrenia in the seven major markets, 2007 and 2017 50 Table 9: Key products in late-stage R&D pipeline for schizophrenia, 2008 51 Table 10: Comparison of leading brands for schizophrenia, 2008 52 Table 11: Zyprexa - Drug profile, 2008 57 Table 12: Impacting factors on Zyprexa revenues, 2007-2017 61 Table 13: Risperdal - Drug profile, 2008 63 Table 14: Impacting factors on Risperdal Oral revenues, 2007-2017 67 Table 15: Risperdal Consta - Drug profile, 2008 71 Table 16: Factors impacting on Risperdal Consta revenues, 2007-2017 76 Table 17: Abilify - Drug profile, 2008 78 Table 18: Impacting factors on Abilify revenues, 2007-2017 83 Table 19: Seroquel - Drug profile, 2008 85 Table 20: Impacting factors on Seroquels revenues, 2007-2017 90 Table 21: Geodon - Drug profile, 2008 92 Table 22: Impacting factors on Geodons revenues, 2007-2017 96 Table 23: Invega - Drug profile, 2008 99 Table 24: Impacting factors on Invega revenues, 2007-2017 103 Table 25: Number of key schizophrenia drugs by type of mechanism of action and phase of development, 2008 110 Table 26: Pipeline drugs in pre-registration for the treatment of schizophrenia, 2008 111 Table 27: Pipeline drugs in Phase III development for the treatment of schizophrenia, 2008 112 Table 28: Pipeline drugs in Phase II development for the treatment of schizophrenia, 2008 112 Table 29: Pipeline drugs in Phase II development for the treatment of cognitive disorder associated with schizophrenia, 2008 115 Table 30: Eli Lillys Zyprexa: key facts 121 Table 31: Impacting factors on Zypadhera sales revenue, 2009-2017 125 Table 32: Satisfaction of unmet needs assessment - Zypadhera (olanzapine depot), 2008 130 Table 33: Clinical trial summary - Zypadhera 132 Table 34: Impacting factors on paliperidone palmitate revenues, 2009-2017 137 Table 35: Comparison of paliperidone palmitate depot versus Risperdal Consta 141 Table 36: Satisfaction of unmet needs assessment - paliperidone palmitate depot, 2008 144 Table 37: Clinical trial summary - paliperidone palmitate 145 Table 38: Ongoing Phase III Clinical trial summary - paliperidone palmitate 146 Table 39: Impacting factors on asenapine revenues, 2009-2017 151 Table 40: Satisfaction of unmet needs assessment - asenapine, 2008 156 Table 41: Phase III clinical trial summary - asenapine, 2008 157 Table 42: Phase I and II clinical trial summary - asenapine, 2008 158 Table 43: Satisfaction of unmet needs assessment - bifeprunox, 2008 170 Table 44: Completed clinical trial summary - bifeprunox (DU127090) 172 Table 45: Ongoing clinical trial summary - bifeprunox 173 Table 46: Impacting factors on lurasidone revenues, 2011-2017 178 Table 47: Satisfaction of unmet needs assessment - lurasidone, 2008 182 Table 48: Ongoing clinical trial summary Lurasidone 183 Table 49: Completed clinical trial summary Lurasidone 184 Table 50: Satisfaction of unmet needs assessment - Staccato loxapine, 2008 197 Table 51: Clinical trial summary - Staccato™ Loxapine, AZ-004 198 Table 52: Impacting factors on LY-2140023revenues, 2014-17 202 Table 53: Satisfaction of unmet needs assessment - LY-2140023, 2008 205 Table 54: Clinical trial summary - LY-2140023 206 Table 55: Satisfaction of unmet needs assessment - iloperidone, 2008 211 Table 56: Phase III Clinical trial summary - Iloperidone oral 212 Table 57: Clinical trial summary - pimavanserin tartrate (ACP-103) 219 Table 58: Phase I clinical trial summary - BL-1020 223 Table 59: Phase II clinical trial summary - BL-1020 224 Table 60: Clinical trial summary - RGH-188 (cariprazine) 228 Table 61: Clinical trial summary - SAM-101 233 Table 62: Clinical trial summary - PF-254592 236 Table 63: Datamonitors launch dates for schizophrenia products across the US, 5EU and Japan, 2008-2017 256 Table 64: Key branded atypical antipsychotics patents expiry dates across the US, the 5EU and Japan (1/2) 257 Table 65: ICD-10 and DSM-IV codes for schizophrenia 260 Table 66: Schizophrenia diagnosis values (%) for key brands sales ($) in the US, 2005-07 260 Table 67: Datamonitor drug assessment parameters 261
List of Figures Figure 1: Schizophrenia-specific sales revenue distribution by drug type across the seven major markets ($m), 2004-2017 5 Figure 2: Datamonitor drug competitive positioning analysis of pipeline drugs in development for schizophrenia in the seven major markets over the forecast period, 2008-2017 6 Figure 4: Schizophrenia sales revenue distribution between typical and atypical antipsychotics in the US, 5EU and Japan ($m), 2004-07 31 Figure 5: Schizophrenia sales volume distribution between typical and atypical antipsychotics (standard units million) in the US, 5EU and Japan, 2004-07 32 Figure 6: Schizophrenia sales revenue ($m) in the US, 5EU and Japan, 2004-07 33 Figure 7: Schizophrenia sales volume (standard units million; SUm) in the US and 5EU, 2004-07 34 Figure 8: Schizophrenia sales revenue distribution between atypical antipsychotics brands and conventional antipsychotics in the US, 5EU and Japan ($m), 2007 35 Figure 9: Key events impacting the schizophrenia market, 2004-08 36 Figure 10: Schizophrenia-specific sales revenue distribution by drug type across the seven major markets ($m), 2004-2017 37 Figure 11: Schizophrenia-specific sales volume distribution by drug type across the seven major markets (SUm), 2004-2017 38 Figure 12: Market share of drug type for schizophrenia across the seven major markets, 2007 and 2017 40 Figure 13: Key events impacting the schizophrenia market, 2007-2017 41 Figure 14: Drivers of brand choice for the treatment of schizophrenia, 2008 53 Figure 15: Zyprexa all-indication promotional spend in the US and 5EU ($m), 2005-07 59 Figure 16: The effect of patent expiry on the sales of Eli Lillys Zyprexa (olanzapine) for schizophrenia in the seven major markets ($m), 2004-2017 60 Figure 17: Risperdal Oral all-indication promotional spend ($m) in the US and 5EU, 2005-07 65 Figure 18: The effect of patent expiry on the sales of Johnson & Johnsons Risperdal Oral (risperidone) for schizophrenia in the seven major markets ($m), 2004-2017 67 Figure 19: Risperdal Consta all-indication promotional spend in the US and 5EU ($m), 2005-07. 73 Figure 20: The effect of patent expiry and paliperidone palmitate depot launch on the sales of Johnson & Johnsons Risperdal Consta (risperidone depot) for schizophrenia in the seven major markets ($m), 2004-2017 75 Figure 21: Abilify all-indication promotional spend in the US and 5EU ($m), 2005-07 81 Figure 22: The effect of patent expiry on the sales of Otsuka/Bristol-Myers Squibbs Abilify (aripiprazole) for schizophrenia in the seven major markets ($m), 2004-2017 82 Figure 23: Seroquel franchise all-indication promotional spend in the US and 5EU ($m), 2005-07 87 Figure 24: Seroquel all-indication promotional expenses by channel in the US and 5EU ($m), 2007 88 Figure 25: The effect of the extended release version and patent expiry on the sales of AstraZenecas Seroquel (quetiapine) for schizophrenia in the seven major markets ($m), 2004-2017 89 Figure 26: Geodon all-indication promotional spend in the US and 5EU ($m), 2005-07 94 Figure 27: The effect of patent expiry on the sales of Pfizers Geodon (ziprasidone) for schizophrenia in the seven major markets ($m), 2004-2017 96 Figure 28: Invega all-indication promotional spend in the US and 5EU ($m), 2005-07 101 Figure 29: The effect of patent expiry on the sales of Johnson & Johnsons Invega (paliperidone) for schizophrenia in the seven major markets ($m), 2004-2017 102 Figure 30: The effect of US launch and patent expiry on the sales of Lundbecks Serdolect for schizophrenia in the 7MM ($m), 2004-2017 106 Figure 31: Forecast sales of Dainippon-Sumitomos Lonasen for schizophrenia in the 7MM ($m), 2004-2017 107 Figure 32: Comparative schizophrenia-specific sales ($m) forecast for key late-stage pipeline drugs in the seven major markets, 2008-2017 119 Figure 33: Datamonitor drug assessment summary of pipeline drugs in development for schizophrenia across the seven major markets,2008-2017 120 Figure 34: Sales forecast for Zypadhera in schizophrenia to 2017 across the seven major markets 124 Figure 35: Eli Lillys schizophrenia sales revenue across the seven major markets, 2004-2017 125 Figure 36: Datamonitors competitive positioning analysis of Zypadhera in schizophrenia across the seven major markets, 2008-2017 126 Figure 37: Sales forecast for paliperidone palmitate in schizophrenia to 2017 across the seven major markets 136 Figure 38: Johnson & Johnsons schizophrenia-specific sales revenue across the seven major markets, 2004-2017 138 Figure 39: Datamonitors competitive positioning analysis of paliperidone palmitate in schizophrenia across the seven major markets, 2008-2017 139 Figure 40: Sales forecast for asenapine in schizophrenia to 2017 across the seven major markets 151 Figure 41: Datamonitors competitive positioning analysis of asenapine in schizophrenia across the seven major markets, 2007-2017 153 Figure 42: Sales forecast for bifeprunox in schizophrenia to 2017, 5EU 167 Figure 43: Datamonitors competitive positioning analysis of bifeprunox in schizophrenia across the 7MM, 2008-17 168 Figure 44: Sales forecast for lurasidone in schizophrenia to 2017 across the seven major markets 178 Figure 45: Datamonitors competitive positioning analysis of lurasidone in schizophrenia across the seven major markets, 2007-2017 179 Figure 46: Staccato system - single dose platform 190 Figure 47: Sales forecast for Staccato loxapine in schizophrenia to 2017 across the seven major markets 191 Figure 48: Datamonitors competitive positioning analysis of Staccato loxapine in schizophrenia across the seven major markets, 2007-2017 192 Figure 49: Sales forecast for LY-2140023 in schizophrenia to 2017across the seven major markets 202 Figure 50: Datamonitors competitive positioning analysis of LY-2140023 in schizophrenia across the seven major markets, 2008-2017 203 Figure 51: Datamonitor drug assessment summary of pipeline drugs in development for schizophrenia over the forecast period 2008-2017 across the seven major markets. 262
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