How Can Emerging Augmentation Strategies Be Differentiated to Maximize Uptake in a Mature and Genericized Market?
Unipolar depression, which includes major depressive disorder (MDD), minor depression, and dysthymia, is a highly prevalent psychiatric disorder; we estimate 87.5 million prevalent cases in the seven major pharmaceutical markets by 2023. Treatment-resistant depression (TRD), a subset of the MDD population, is frequently defined as an inadequate response to two trials of major antidepressants from two different drug classes. Atypical antipsychotics—e.g., aripiprazole (Bristol-Myers Squibb/Otsuka Pharmaceutical’s Abilify), a therapy approved for MDD patients who do not adequately respond to antidepressant therapy—are increasingly used to augment antidepressants in TRD treatment. The unipolar depression market, including therapies approved for TRD, is a mature market with a limited number of branded agents. Nevertheless, opportunity exists for emerging drugs that can provide efficacy and/or safety in TRD that is comparable to or better than that of atypical antipsychotic augmentation.