不安障害治療市場の現状と今後の可能性

Introduction

Anxiety disorders are considered the most prevalent of psychiatric disorders, with a high incidence of comorbidity with other psychiatric disorders.

However, poor diagnosis rates and treatment outcomes mean that there is still considerable scope for manufacturers to move into the anxiety market.

The exact prevalence of anxiety disorders is difficult to quantify due to the lack of epidemiological data, plus the high incidence of comorbidity with other psychiatric disorders including depression. Diagnosis and treatment are frequently hindered by failure of physicians and patients to recognize the disorder; and when patients are treated, a considerable proportion of patients require second-line therapy. New treatment strategies are desperately needed.

Key findings and highlights

• Despite a fifth of the total population across the seven major markets suffering from an anxiety disorder, only a quarter of these individuals are diagnosed and therefore treated. As a result, drug manufacturers are failing to maximize revenues from the anxiety disorders market. Investment in awareness campaigns is essential.
• Paroxetine is the gold standard treatment for anxiety disorders across the seven major markets. Nonetheless, opportunities still exist for manufacturers to gain market share in anxiety disorders and countries where the uptake of paroxetine has been less marked.
• With almost a third of patients requiring second-line therapy, there is a significant need for anxiety drugs with improved efficacy. Drug developers must begin investing in clinical trials for anxiety specific drugs that demonstrate improved efficacy over current therapies.

Reasons to buy

• Assess the size of the drug-treated population by gaining an understanding of the prevalence of anxiety with comorbid psychiatric disorders
• Target physicians more effectively, through an understanding of prescribing behavior
• Identify commercial opportunities by benchmarking current products and assessing unmet needs and future market potential

Table of contents

EXECUTIVE SUMMARY

Scope of the analysis

Datamonitor insight into the anxiety disorders market

Key metrics

INTRODUCTION AND SCOPE

Coverage of the Stakeholder Insight Survey

- Epidemiology and diagnosis of anxiety disorders

- Referral patterns

- Treatment of anxiety disorders

- Drug profiles

COUNTRY TREATMENT TREES

US

Japan

France

Germany

Italy

Spain

UK

EPIDEMIOLOGY AND PATIENT SEGMENTATION

Key findings

Definitions and classification

Etiology of anxiety disorders

- Generalized anxiety disorder

- Panic disorder

- Social anxiety disorder

- Acute stress disorder

- Obsessive-compulsive disorder

- Post-traumatic stress disorder

- Premenstrual dysphoric disorder

- Agoraphobia

- Specific phobias

Epidemiology of anxiety

- Prevalence of anxiety

- Gender and age

Segmentation of anxiety disorders

- Acute versus chronic anxiety

- Prevalence of anxiety disorder types

Comorbidities of anxiety disorders

- Generalized anxiety disorder

- Panic disorder

- Social anxiety disorder

- Post-traumatic stress disorder

- Premenstrual dysphoric disorder

Prevalence of comorbidities across the seven major markets

DIAGNOSIS AND TREATMENT

Key findings

Classification of anxiety disorders

- ICD-10 classification

- DSM-IV classification

Diagnostic criteria

- Panic disorder

- Obsessive-compulsive disorder

- Generalized anxiety disorder

- Post-traumatic stress disorder

- Acute stress disorder

- Social anxiety disorder

- Specific phobias

- Agoraphobia

- Premenstrual dysphoric disorder (PMDD)

- Anxiety disorder not otherwise specified

- Other anxiety disorders

Diagnosis

- Diagnosis rates

- Referral patterns

Treatment of anxiety disorders

- Treatment guidelines

- Drug overview

PRESCRIBING TRENDS AND INFLUENCING FACTORS

Key findings

Introduction

Prescribing trends

- Pharmacological versus non-pharmacological treatment

- Treatment priority in comorbid patients

- Treatment lines

Treatment of anxiety disorders

- Treatment of acute versus chronic anxiety

- Treatment of generalized anxiety disorder

- Treatment of panic disorders

- Treatment of social anxiety disorder

- Treatment of acute stress disorder

- Treatment of obsessive-compulsive disorder

- Treatment of post-traumatic stress disorder

- Treatment of premenstrual dysphoric disorder

- Treatment of agoraphobia

- Treatment of specific phobia

IMPROVING TREATMENT OUTCOMES

Key findings

Prescribing influences

Unmet needs

- Physician education

- Patient compliance

- Efficacy

Product development

- Pregabalin

- Pagoclone

- LY 544344

Bibliography

Physician research methodology

- Physician sample breakdown

Contributing experts

The survey questionnaire

- Physician details

- Epidemiology of anxiety disorders

- Referral patterns

- Treatment

- Comorbid conditions

- Acute versus chronic

- Drug profiles

About Datamonitor

- About Datamonitor Healthcare

- Datamonitor Healthcare's research and analysis methodologies

Datamonitor Healthcare's therapy area capabilities

- About the CNS analysis team

- Datamonitor Healthcare's Consulting expertise

- Key therapy team members

Disclaimer

TABLES

Table 1: Prevalence of anxiety disorders across the seven major markets, 2003

Table 2: Prevalence rate of sub-categories of anxiety disorder in the general population across the seven major markets

Table 3: Comparison of prevalence rates of anxiety disorders in the general population

Table 4: Prevalence of panic disorder in five of the major markets

Table 5: Prevalence of SAD in four of the major markets

Table 6: Prevalence of OCD

Table 7: Prevalence of a comorbid psychiatric condition with anxiety disorders across the seven major markets

Table 8: ICD-10 classification codes for anxiety disorders

Table 9: DSM-IV-TR classification codes for anxiety disorders

Table 10: Population correctly diagnosed with anxiety disorders, 2003-11

Table 11: Proportion of patients diagnosed with an anxiety disorder that fall into each sub-category, 2003

Table 12: Proportion of patients referred to different medical professional by PCPs, 2003

Table 13: Proportion of patients referred to psychiatrist by different medical professionals

Table 14: WFSBP guidelines for panic disorder and agoraphobia treatment

Table 15: WFSBP guidelines for GAD treatment

Table 16: WFSBP guidelines for SAD treatment

Table 17: WFSBP guidelines for OCD treatment

Table 18: WFSBP guidelines for PTSD treatment

Table 19: Advantages and disadvantages of anti-anxiety drugs

Table 20: Proportion of patients receiving pharmacological and non-pharmacological treatment for anxiety disorders in the seven major markets

Table 21: Top prescription drugs used in first-line treatment of GAD in the seven major markets

Table 22: Top prescription drugs used in second-line treatment of GAD in the seven major markets

Table 23: Top prescription drugs used in first-line treatment of panic disorder in the seven major markets

Table 24: Top prescription drugs used in second-line treatment of panic disorder in the seven major markets

Table 25: Top prescription drugs used in first-line treatment of SAD in the seven major markets

Table 26: Top prescription drugs used in second-line treatment of SAD in the seven major markets

Table 27: Top prescription drugs used in first-line treatment of acute stress disorder in the seven major markets

Table 28: Top prescription drugs used in second-line treatment of acute stress disorder in the seven major markets

Table 29: Top prescription drugs used in first-line treatment of OCD in the seven major markets

Table 30: Top prescription drugs used in second-line treatment of OCD in the seven major markets

Table 31: Top prescription drugs used in first-line treatment of PTSD in the seven major markets

Table 32: Top prescription drugs used in second-line treatment of PTSD in the seven major markets

Table 33: Top prescription drugs used in first-line treatment of PMDD in the seven major markets

Table 34: Top prescription drugs used in second-line treatment of PMDD in the seven major markets

Table 35: Top prescription drugs used in first-line treatment of agoraphobia in the seven major markets

Table 36: Top prescription drugs used in second-line treatment of agoraphobia in the seven major markets

Table 37: Top prescription drugs used in first-line treatment of specific phobia in the seven major markets

Table 38: Top prescription drugs used in second-line treatment of specific phobia in the seven major markets

Table 39: Future anxiolytics

Table 40: US physician sample breakdown, 2003

Table 41: Japan physician sample breakdown, 2003

Table 42: France physician sample breakdown, 2003

Table 43: Germany physician sample breakdown, 2003

Table 44: Italy physician sample breakdown, 2003

Table 45: Spain physician sample breakdown, 2003

Table 46: UK physician sample breakdown, 2003

FIGURES

Figure 1: Total drug treated anxiety disorders population in the seven major markets, 2003

Figure 2: First- and second-line therapeutic strategies for different anxiety disorders in the US, 2003

Figure 3: First- and second-line therapeutic strategies for different anxiety disorders in Japan, 2003

Figure 4: First- and second-line therapeutic strategies for different anxiety disorders in France, 2003

Figure 5: First- and second-line therapeutic strategies for different anxiety disorders in Germany, 2003

Figure 6: First- and second-line therapeutic strategies for different anxiety disorders in Italy, 2003

Figure 7: First- and second-line therapeutic strategies for different anxiety disorders in Spain, 2003

Figure 8: First- and second-line therapeutic strategies for different anxiety disorders in the UK, 2003

Figure 9: Prevalence of anxiety disorders across the seven major markets

Figure 10: Patient distribution: acute versus chronic anxiety

Figure 11: Prevalence of patients with specific symptoms of anxiety

Figure 12: Prevalence rate of different types of anxiety disorder in the general population across the seven major markets

Figure 13: Prevalence of GAD across the seven major markets

Figure 14: Prevalence of panic disorder across the seven major markets

Figure 15: Prevalence of SAD across the seven major markets

Figure 16: Prevalence of acute stress disorder across the seven major markets

Figure 17: Prevalence of OCD across the seven major markets

Figure 18: Prevalence of PTSD across the seven major markets

Figure 19: Prevalence of PMDD across the seven major markets

Figure 20: Prevalence of agoraphobia across the seven major markets

Figure 21: Prevalence of specific phobia across the seven major markets

Figure 22: Prevalence of other anxiety disorders across the seven major markets

Figure 23: Prevalence of comorbidities with anxiety disorders in the US

Figure 24: Prevalence of comorbidities with anxiety disorders in Japan

Figure 25: Prevalence of comorbidities with anxiety disorders in France

Figure 26: Prevalence of comorbidities with anxiety disorders in Germany

Figure 27: Prevalence of comorbidities with anxiety disorders in Spain

Figure 28: Prevalence of comorbidities with anxiety disorders in Italy

Figure 29: Prevalence of comorbidity with anxiety disorders in the UK

Figure 30: Anxiety disorders diagnostic decision tree (DSM-IV)

Figure 31: Population correctly diagnosed with an anxiety disorder

Figure 32: Diagnosis rates of anxiety disorders by PCPs versus psychiatrists

Figure 33: Proportion of patients that consult a physician directly (PCPs and psychiatrists) in the seven major markets

Figure 34: A comparison of proportion of patients that consult either a PCP or psychiatrist directly for anxiety

Figure 35: Proportion of patients referred to other medical professionals by PCPs

Figure 36: Proportion of patients referred to different medical professionals by PCPs

Figure 37: Proportion of patients referred to psychiatrist by different medical professionals

Figure 38: Proportion of patients receiving pharmacological, non-pharmacological or both forms of therapy in treatment of anxiety disorders in the seven major markets

Figure 39: Proportion of physicians across the seven major markets who believe anxiety or depression takes priority in the treatment of patients with comorbid anxiety and depression

Figure 40: Proportion of patients progressing to second-line therapy in the seven major markets

Figure 41: Length of time patients receive first-line therapy before progressing to second-line therapy in the seven major markets

Figure 42: Most frequently prescribed combination therapies used in the treatment of acute anxiety disorders in the seven major markets

Figure 43: Most frequently prescribed combination therapies used in the treatment of chronic anxiety disorders in the seven major markets

Figure 44: Top prescription drugs used for first-line treatment of GAD in the seven major markets

Figure 45: Top prescription drugs used in the second-line treatment of GAD in the seven major markets

Figure 46: Top prescription drugs used in the treatment of comorbid GAD and depression in the seven major markets

Figure 47: Top prescription drugs used for first-line treatment of panic disorder in the seven major markets

Figure 48: Top prescription drugs used in the second-line treatment of panic disorder in the seven major markets

Figure 49: Top prescription drugs used in the treatment of comorbid panic disorder and depression in the seven major markets

Figure 50: Top prescription drugs used for first-line treatment of SAD in the seven major markets

Figure 51: Top five prescription drugs used in the second-line treatment of SAD in the seven major markets

Figure 52: Top prescription drugs used in the treatment of comorbid SAD and depression in the seven major markets

Figure 53: Top prescription drugs used for first-line treatment of acute stress disorder in the seven major markets

Figure 54: Top prescription drugs used in the second-line treatment of acute stress disorder in the seven major markets

Figure 55: Top prescription drugs used in the treatment of comorbid acute stress disorder and depression in the seven major markets

Figure 56: Top prescription drugs used for first-line treatment of OCD in the seven major markets

Figure 57: Top prescription drugs used in the second-line treatment of OCD in the seven major markets

Figure 58: Top prescription drugs used in the treatment of comorbid OCD and depression in the seven major markets

Figure 59: Top prescription drugs used in first-line treatment of PTSD in the seven major markets

Figure 60: Top prescription drugs used in the second-line treatment of PTSD in the seven major markets

Figure 61: Top prescription drugs used in the treatment of comorbid PTSD and depression in the seven major markets

Figure 62: Top prescription drugs used for first-line treatment of PMDD in the seven major markets

Figure 63: Top prescription drugs used in the second-line treatment of PMDD in the seven major markets

Figure 64: Top prescription drugs used in the treatment of comorbid PMDD and depression in the seven major markets

Figure 65: Top prescription drugs used for first-line treatment of agoraphobia in the seven major markets

Figure 66: Top prescription drugs used in the second-line treatment of agoraphobia in the seven major markets

Figure 67: Top prescription drugs used in the treatment of agoraphobia and depression in the seven major markets

Figure 68: Top prescription drugs used for first-line treatment of specific phobia in the seven major markets

Figure 69: Top prescription drugs used in the second-line treatment of specific phobia in the seven major markets

Figure 70: Top prescription drugs used in the treatment of comorbid specific phobia and depression in the seven major markets

Figure 71: Key attributes most likely to influence drug choice

Figure 72: Rated performance of main drug classes used in the treatment of anxiety disorders

Figure 73: Rated performance of main drug classes used in the treatment of anxiety disorders

Figure 74: Key unmet needs

Figure 75: Datamonitor's Healthcare Consultancy

Figure 76: Datamonitor Healthcare's Therapeutic Consulting capabilities