Major Depressive Disorder (DSM-V) – Access & Reimbursement – Detailed, Expanded Analysis (US)

Numerous drugs from multiple drug classes are used as monotherapies and/or adjunctive therapies to treat major depressive disorder (MDD). The prominent use of generically available drugs (e.g., selective serotonin reuptake inhibitors) as early-line treatments contributes to the market access challenges that branded therapies face when entering this market. Of note, brand-only drugs (e.g., Lundbeck / Takeda’s Trintellix, Lundbeck / Otsuka Pharmaceutical’s Rexulti) largely compete for use in treatment-resistant depression (TRD) patients. Nevertheless, given the high unmet need for effective treatments for inadequate responders to early-line therapies and treatment-resistant patients, newer-to-market drugs (e.g., Janssen’s Spravato, Axsome Therapeutics’ Auvelity) and late-phase emerging drugs (e.g., COMPASS Pathways’ COMP360 psilocybin) seem promising. Although the expanding presence of generic drugs has given payers more leverage to control drug treatment costs in MDD, understanding the current and expected influence of clinical metrics and value-for-dollar on market access and medical practice is key for marketers and developers of new therapies for MDD.


  • In this mature and highly generic treatment landscape, what actions can marketers of new therapies for MDD take to gain market access and thus ensure uptake?
  • How do payer policies affect the prescribing of branded antidepressants (e.g., Lundbeck / Takeda’s Trintellix, Janssen’s Spravato) and branded oral atypical antipsychotics (i.e., Lundbeck / Otsuka Pharmaceutical’s Rexulti, AbbVie’s Vraylar) in this genericized market?
  • What is the physician-reported treatment journey for TRD patients? How is it influenced by the market access and reimbursement environment for Spravato in TRD?
  • How do payers expect to reimburse an emerging psychedelic therapy COMP360 psilocybin for TRD? What is the anticipated impact of payer restrictions / formulary placement on psychiatrists’ prescribing of such a therapy for TRD patients?


Geography: United States

Primary research: Survey of 101 U.S. psychiatrists, survey of 30 U.S. MCO PDs / MDs

Fingertip formulary: Formulary coverage and restrictions data for MDD therapies by commercial plans covering approximately 169.5 million lives nationally.

Key drugs covered: Trintellix, Spravato, Auvelity, Rexulti, Vraylar, Caplyta, COMP360 psilocybin, zuranolone

Content highlights:

Reimbursement and contracting.

Access and prescribing.

Opportunities and challenges for emerging therapies.

Disease-specific special topic: Treatment-Resistant Depression.


U.S. Access & Reimbursement provides integrated brand- and disease-level insight on reimbursement dynamics and the impact of U.S. payer policy on physician prescribing behavior in the market access environment. Each report includes up-to-date analyses of drug coverage and restriction policies as well as payer and prescriber perspectives on key marketed drugs and their receptivity to emerging therapies.

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