 PhysicianForum --
September 2003
 In This Issue...
The U.S. antidepressant market
has grown vigorously in recent years. Between 1998 and 2002, sales at
ex-manufacturer prices increased from $7.1 billion to $12.5 billion, a compound
annual growth rate of 15%. Selective serotonin reuptake inhibitors (SSRIs) have
long been the main drivers of growth in the U.S. antidepressant market. In 2002, however,
total sales of SSRIs in the United States declined by 4.4% in
dollar terms-largely as a consequence of the expiration of the patent on Eli
Lilly’s Prozac (fluoxetine). Generics competition slashed prices by more than
80%, and total dollar sales of fluoxetine fell by 52% in 2002. The
market faces the prospect of even greater upheaval in the near future. Two
other leading SSRIs-Forest’s Celexa (citalopram) and GlaxoSmithKline’s Paxil (paroxetine)-could
encounter generics competition by early 2005. The availability of three generic
SSRIs would transform the dynamics of the antidepressant market and present
serious challenges, not just for Celexa and Paxil, but for other leading
antidepressants.
Decision Resources’ PhysicianForum
survey “The Potential Impact of Generic Citalopram and Paroxetine on the U.S.
Antidepressant Market" explores current antidepressant prescribing
patterns for depression and anxiety and assesses how health plans and
physicians would respond to the introduction of new generic SSRIs. We surveyed
56 primary care physicians (PCPs), 30 psychiatrists, and 24 health maintenance
organization (HMO) pharmacy directors and compared their responses to determine
similarities and differences.
This study answers the following
critical questions:
- What is the formulary status of the leading antidepressants?
- Which drug attributes and other factors do HMOs consider most
important in formulary decision making?
- How do HMOs perceive prescribing patterns for depression and
anxiety?
- How satisfied are PCPs and psychiatrists with current antidepressants?
- Which drugs are PCPs’ and psychiatrists’ current therapies of
choice for a range of depressive and anxiety disorders, and what would
physicians choose if citalopram and paroxetine were available as generics?
- Which SSRIs do physicians consider the safest and most efficacious
on the market?
- What are the drug attributes and extraneous factors that
physicians consider most important when selecting an antidepressant to
prescribe?
- What do physicians believe to be the key strengths and weaknesses
of Celexa and Paxil?
- What is the probability that patients will be switched to a
different antidepressant when generic citalopram and paroxetine reach the
market?
- To what extent would cost of therapy influence physicians’
likelihood of prescribing generic citalopram and paroxetine?
- Would physicians prefer generic citalopram, fluoxetine, or paroxetine
for various disorders?.
|
