US psychiatrists’ views on prescribing Otsuka/Lundbeck’s brexpiprazole

26 June 2014

Surveyed US psychiatrists are receptive to novel adjunctive therapies to antidepressants for treatment-resistant depression (TRD) and would prescribe Japanese drugmaker Otsuka (TYO: 4768) and Danish CNS specialist Lundbeck’s (LUND: CO) emerging atypical antipsychotic brexpiprazole to a mean 12% of their drug-treated TRD patients in 2015.

According to new research from Decision Resources Group, this value is slightly lower than the 16% patient share surveyed psychiatrists currently estimate for Bristol-Myers Squibb (NYSE: BMY)/Otsuka’s Abilify (aripiprazole). Additionally, nearly one-third of surveyed psychiatrists willing to prescribe brexpiprazole would be most compelled to switch their TRD patients from adjunctive treatment with Abilify if brexpiprazole offered a lower risk of restlessness and/or akathisia (restless movements, inner restlessness and distress) compared to Abilify.

Other key findings from the Physician and Payer Forum report include:

Physician approaches to TRD treatment: Surveyed primary care physicians (PCPs) and psychiatrists indicate that similar percentages of their patients with major depressive disorder (MDD) have TRD (around one-third), and they take comparable treatment steps to manage their TRD patients. Responses from surveyed physicians indicate that increasing the therapeutic dose followed by switching among the selective serotonin and/or norepinephrine reuptake inhibitors are the most common early-line approaches in treatment of TRD patients; antipsychotic drugs are most likely to be added as the third line of therapy or later.
Hurdles for recently launched antidepressants: The survey data generally finds that physicians encounter minimal reimbursement hurdles when prescribing branded antidepressants. However, responses from surveyed managed care organization directors suggest that newer-to-market agents Forest Laboratories/Pierre Fabre’s Fetzima(levomilnacipran), Takeda/Lundbeck’s Brintellix (vortioxetine) and Dainippon Sumitomo/Sunovion’s Latuda (lurasidone) are in danger of remaining excluded from Medicare prescription drug formularies in one year’s time, likely due to the widespread availability of inexpensive generics and greater cost containment pressures on these plans compared with commercial plans.

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