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Stakeholder Insight: Anxiety Disorders - More Than Just a ComorbidityPublished by: Datamonitor Published: Mar. 18, 2004 - 210 Pages Table of ContentsTABLE OF CONTENTS CHAPTER 1 EXECUTIVE SUMMARY 3 Scope of the analysis 3 Datamonitor insight into the anxiety disorders market 4 Despite approximately 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 potential revenues from the anxiety disorders market. Investing in awareness campaigns would provide a significant boost to revenues. 4 Paroxetine is considered the gold standard treatment for anxiety disorders across the seven major markets. Manufacturers wishing to challenge the leading position must be able to demonstrate superior efficacy, onset of action, and fewer side effects than paroxetine. Nonetheless, opportunities still exist for gaining market share in anxiety disorders and within countries, such as Germany, where the uptake of paroxetine has been less marked. 5 With approximately 30% 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. Demonstration to physicians of the benefits that the new chemical entities provide, compared to paroxetine, will be key to a successful uptake. 8 Key metrics 9 CHAPTER 2 INTRODUCTION AND SCOPE 19 Coverage of the Stakeholder Insight Survey 19 Epidemiology and diagnosis of anxiety disorders 19 Referral patterns 19 Treatment of anxiety disorders 20 Drug profiles 20 CHAPTER 3 COUNTRY TREATMENT TREES 21 US 22 Japan 23 France 24 Germany 25 Italy 26 Spain 27 UK 28 CHAPTER 4 EPIDEMIOLOGY AND PATIENT SEGMENTATION 29 Key findings 29 Definitions and classification 30 Etiology of anxiety disorders 31 Generalized anxiety disorder 32 Panic disorder 32 Social anxiety disorder 33 Acute stress disorder 33 Obsessive-compulsive disorder 34 Post-traumatic stress disorder 35 Premenstrual dysphoric disorder 35 Agoraphobia 36 Specific phobias 36 Epidemiology of anxiety 37 Prevalence of anxiety 37 Gender and age 39 Generalized anxiety disorder 40 Panic disorder 40 Social anxiety disorder 41 Obsessive-compulsive disorder 41 Post-traumatic stress disorder and acute stress disorder 42 Specific phobias 43 Agoraphobia 43 Segmentation of anxiety disorders 43 Acute versus chronic anxiety 43 Prevalence of anxiety disorder types 46 Generalized anxiety disorder 49 Panic disorder 50 Social anxiety disorder 52 Acute stress disorder 54 Obsessive-compulsive disorder 56 Post-traumatic stress disorder 58 Premenstrual dysphoric disorder 59 Agoraphobia 61 Specific phobias 62 Other anxiety disorders 63 Comorbidities of anxiety disorders 64 Generalized anxiety disorder 65 Panic disorder 65 Social anxiety disorder 65 Post-traumatic stress disorder 66 Premenstrual dysphoric disorder 66 Prevalence of comorbidities across the seven major markets 67 CHAPTER 5 DIAGNOSIS AND TREATMENT 75 Key findings 75 Classification of anxiety disorders 76 ICD-10 classification 77 DSM-IV classification 78 Diagnostic criteria 78 Panic disorder 78 Obsessive-compulsive disorder 79 Generalized anxiety disorder 80 Post-traumatic stress disorder 81 Acute stress disorder 82 Social anxiety disorder 84 Specific phobias 84 Agoraphobia 85 Premenstrual dysphoric disorder (PMDD) 85 Anxiety disorder not otherwise specified 86 Other anxiety disorders 87 Diagnosis 87 Diagnosis rates 89 Referral patterns 93 Treatment of anxiety disorders 99 Treatment guidelines 99 World Federation of Societies of Biological Psychiatry guidelines 100 Drug overview 104 CHAPTER 6 PRESCRIBING TRENDS AND INFLUENCING FACTORS 106 Key findings 106 Introduction 107 Prescribing trends 107 Pharmacological versus non-pharmacological treatment 107 Treatment priority in comorbid patients 109 Treatment lines 111 Treatment of anxiety disorders 114 Treatment of acute versus chronic anxiety 114 Treatment of generalized anxiety disorder 115 First-line treatment of generalized anxiety disorder 115 Second-line treatment of generalized anxiety disorder 117 Treatment of comorbid generalized anxiety disorder and depression 120 Treatment of panic disorders 121 First-line treatment of panic disorder 121 Second-line treatment of panic disorder 122 Treatment of comorbid panic disorder and depression 124 Treatment of social anxiety disorder 126 First-line treatment of social anxiety disorder 126 Second-line treatment of social anxiety disorder 128 Treatment of comorbid social anxiety disorder and depression 129 Treatment of acute stress disorder 131 First-line treatment of acute stress disorder 131 Second-line treatment of acute stress disorder 133 Treatment of comorbid acute stress disorder and depression 134 Treatment of obsessive-compulsive disorder 136 First-line treatment for obsessive-compulsive disorder 136 Second-line treatment of obsessive-compulsive disorder 138 Treatment of comorbid obsessive-compulsive disorder and depression 139 Treatment of post-traumatic stress disorder 141 First-line treatment of post-traumatic stress disorder 141 Second-line treatment of post-traumatic stress disorder 143 Treatment of comorbid post-traumatic stress disorder and depression 144 Treatment of premenstrual dysphoric disorder 146 First-line treatment of premenstrual dysphoric disorder 146 Second-line treatment of premenstrual dysphoric disorder 148 Treatment of comorbid premenstrual dysphoric disorder and depression 149 Treatment of agoraphobia 151 First-line treatment of agoraphobia 151 Second-line treatment of agoraphobia 152 Treatment of comorbid agoraphobia and depression 154 Treatment of specific phobia 156 First-line treatment of specific phobia 156 Second-line treatment of specific phobia 157 Treatment of comorbid specific phobias and depression 159 CHAPTER 7 IMPROVING TREATMENT OUTCOMES 161 Key findings 161 Prescribing influences 162 Unmet needs 164 Physician education 165 Patient compliance 166 Efficacy 168 Product development 169 Pregabalin 170 Pagoclone 170 GAD 171 Panic disorder 171 LY 544344 171 APPENDIX A 172 Bibliography 172 APPENDIX B 179 Physician research methodology 179 Physician sample breakdown 179 US 179 Japan 180 France 180 Germany 181 Italy 181 Spain 182 UK 182 Contributing experts 183 APPENDIX C 184 The survey questionnaire 184 Physician details 184 Epidemiology of anxiety disorders 185 Referral patterns 189 Treatment 192 Comorbid conditions 198 Acute versus chronic 199 Drug profiles 202 About Datamonitor 204 About Datamonitor Healthcare 204 Datamonitor Healthcare’s research and analysis methodologies 205 Datamonitor Healthcare’s therapy area capabilities 205 About the CNS analysis team 206 Datamonitor Healthcare’s Consulting expertise 207 Datamonitor’s Therapeutic Consulting expertise 208 Key therapy team members 208 Lynda Lynch, Director CNS 208 David Abramson, Therapeutic Lead Consultant 209 Disclaimer 210 AbstractIntroductionAnxiety disorders are considered the most prevalent of psychiatric disorders. However, poor diagnosis rates and treatment outcomes mean that there is still considerable scope for manufacturers to move into the anxiety market. Based on 180 interviews with primary care physicians and psychiatrists, this report will analyze the commercial opportunities in the anxiety disorders market Scope Prevalence and diagnosis rates of anxiety disorders (including prevalence of comorbidity with other psychiatric disorders) In-depth analysis of first- and second-line treatment choices Key differences in treatment practices for acute versus chronic anxiety and comorbid anxiety Evaluation of key attributes influencing drug choice and physician perception of current drug therapies to identify greatest unmet needs in treatment Report 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 Purchase 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 Get Full Details About This Report >> |
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