Global depression market

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Although depression is a global phenomenon, the global market for antidepressants is unevenly distributed. In 2004, the US antidepressant market accounted for 71% of the global market compared to 24% in Europe and 5% in the rest of the world (mainly Japan). While depression is a mature market, there are several key drivers for its further growth including: (1) improvements in the efficacy; (2) speed of onset; (3) safety/tolerability of NCEs; and (4) a reduction in remission rates and relapse/recurrence.

A National Institutes of Mental Health (NIMH) National Comorbidity Survey of more than 9000 US adults in 2005 using DSM-IV-TR (Text Revision 2001) criteria found that 6% of those studied had a debilitating mental illness, yet treatment was difficult to obtain, with only one-third of those in care receiving minimally adequate treatment, such as appropriate drugs or a few hours of therapy over a period of several months. In general, the investigators found that things had not changed much over the past decade. A Massachusetts Institute of technology (MIT) survey estimated the direct and indirect cost of mood disorders in the US to be $43 billion in 1990.9 Depressed individuals incur almost twice the medical cost burden as nondepressed patients, the main part (80%) being for medical care rather than psychiatric or psychological services, with the bulk of antidepressant prescriptions (approximately 80% worldwide) being written by primary care physicians.

Effective treatment for moderate-to-severe depression includes a combination of somatic therapies (pharmacotherapy or electroconvulsive therapy (ECT)). ECT has been rejuvenated for the treatment for the most severe, melancholic depressions, particularly in the elderly (who are more prone to adverse effects of drugs) and in patients who do not respond to antidepressants.

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