Most-used agents in US bipolar disorder treatment sector; report

24 October 2014

Through analysis of US longitudinal patient-level claims data, Bristol-Myers Squibb (NYSE: BMY) and Otsuka’s (TYO: 4768) Abilify (aripiprazole) was the antipsychotic that captured the highest first-line patient share among newly-diagnosed bipolar disorder patients.

Although multiple generic antipsychotics are now available, Abilify’s favorably perceived tolerability profile and its regulatory approval for multiple stages of the illness drive its use in bipolar disorder over that of other atypical antipsychotics, according to a new report from Decision Resources Group.

Other key findings from the report, titled Treatment Algorithms in Bipolar Disorder, include:

Patient share for lamotrigine in first three lines: Lamotrigine (GlaxoSmithKline’s Lamictal brand, generics) continues to lead other individual agents in patient share among newly-diagnosed bipolar disorder patients across the first three lines of therapy, likely due to physician perception that the agent is beneficial for preventing and treating the depressive phase of bipolar disorder.
Abilify’s patient share among atypical antipsychotics: Abilify captured the second-highest patient share among atypical antipsychotics in recently treated bipolar disorder patients during the key therapy period. Abilify and quetiapine (AstraZeneca’s Seroquel brand, generics) compete closely for patient share among recently treated patients; however despite quetiapine’s generic entry in March 2012, Abilify’s patient share has remained relatively stable during the past five quarters under study.
Increased patient share for Latuda: Although it lags considerably behind Abilify’s and quetiapine’s patient shares in recently treated bipolar disorder patients, the patient share of Latuda (lurasidone) (Sumitomo Dainippon Pharma/Sunovion/Takeda) as increased markedly from fourth-quarter 2012 to the fourth quarter of 2013 key therapy period. This may be due to the drug’s lower incidence of weight gain compared to other atypical antipsychotics.
Cost constraints owing to availability of generics: Decision Resources Group expects Latuda’s patient share will continue to increase thanks in part to the 2013 expanded approval as a monotherapy for bipolar depression, although the drug will likely not reach as high a patient share as quetiapine or Abilify given the cost constraints of a market dominated by an increasing number of generic products.

Lamotrigine among most common monotherapies

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