Key Findings from Treatment Algorithms: Generalized Anxiety Disorder

Decision Resources, Inc, December 2011, Pages: 35

In a cost-conscious environment, first-line treatment of generalized anxiety disorder (GAD) is dominated by selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines owing to the availability of generic agents in these drug classes.

Branded agents, including the SSRI Lexapro (Forest Laboratories/Lundbeck’s escitalopram) and the serotonin/norepinephrine reuptake inhibitors (SNRIs) Cymbalta (Eli Lilly’s duloxetine) and Pristiq (Pfizer’s desvenlafaxine), contend with low-cost SSRIs and benzodiazepines for use in the GAD patient population and are usually relegated to later lines of treatment.

Nevertheless, our analysis shows that of those GAD patients who move to second-line therapy within one year of diagnosis, a majority move to a third-line therapy in one year, underscoring the significant percentage of treatment-refractory GAD patients and the opportunity for agents used in later lines.

Treatment of refractory GAD patients presents an opportunity for branded agents in alternative drug classes (e.g., atypical antipsychotics such as AstraZeneca’s Seroquel/Seroquel XR [quetiapine/quetiapine extended-release], Bristol-Myers Squibb/Otsuka Pharmaceuticals’ Abilify [aripiprazole] or antiepileptics such as Pfizer’s Lyrica [pregabalin]) that can provide symptom management to patients who do not respond to an SSRI, benzodiazepine, or SNRI.

Indeed, use of adjunctive GAD therapies is significant in later lines of therapy despite the increasingly cost sensitive healthcare environment. Using patient-level claims data, this report determines the share of each currently marketed drug by line of therapy, evaluates therapy flow, and analyzes why key drugs are chosen over others.

1. Background
a) Publication Update
b) Report Contents and Features
c) Current Practice Guidelines
d) Key U.S. Market Events Influencing Treatment Selection

2. Key Findings for Newly Diagnosed Patients
a) Executive Summary
b) Graphical Views

3. Key Findings for Recently Treated Patients
a) Executive Summary
b) Graphical Views

4. Key Findings by Product
a) Lexapro
b) Cymbalta
c) Pristiq
d) Seroquel
e) Abilify

5. Appendix: Methodology

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