The CNS Market Outlook to 2012

Executive Summary 12
Patient potential 12
Global market analysis 13
Pipeline analysis 14
Competitive landscape 15

Chapter 1 Epidemiology of CNS disorders 18
Summary 18
Introduction 19
Alzheimer’s disease 21
Overview 21
Diagnosis, treatment and management 22
Epidemiology 25
Forecast epidemiology 27
Major depressive disorder (MDD) 28
Overview 28
Diagnosis, treatment and management 30
Epidemiology 33
Forecast epidemiology 34
Schizophrenia 35
Overview 35
Diagnosis, treatment and management 36
Epidemiology 38
Forecast epidemiology 39
Migraine 41
Overview 41
Diagnosis, treatment and management 42
Epidemiology 43
Forecast epidemiology 45
Epilepsy 46
Overview 46
Diagnosis, treatment and management 46
Epidemiology 47
Forecast epidemiology 48
Parkinson’s disease 50
Overview 50
Diagnosis, treatment and management 51
Epidemiology 53
Forecast epidemiology 54

Chapter 2 Global market analysis 58
Summary 58
Introduction 59
Market analysis by country 59
Licensing/generics trends 60
Market analysis by indication 61
Leading brands dynamics 65
Key events in the CNS disorders market, 68
Revised suicidal warning labeling for SSRI anti depressants 68
Increased risk of bone fractures associated with the use of SSRIs 68
Launch of Lyrica (pregabalin) as a replacement product for Pfizer’s
Neurontin (gabapentin) 68
US FDA calls for voluntary withdrawal of all pergolide-based products 69
Launch for first transdermal patch formulation of Novartis’ Exelon for the
treatment of AD 69
Arrival of generic competition to key products in the CNS market in 2005-6 69
Depression 71
Market analysis by drug class 71
Competitive dynamics of anti-depressants 72
Leading brands in the Anti-depressants market 73
Selective Serotonin Reuptake Inhibitors (SSRIs) 74
Market dynamics 75
Key brands analysis 76
Selective Norepinephrine Reuptake Inhibitors (SNRIs) 85
Key brands analysis 86
Others 90
Anti-depressants sales forecasts to 2012 93
Alzheimer’s disease 94
Market analysis by drug class 94
Competitive dynamics of subclasses of anti-Alzheimer’s disease 96
Leading brands in the Anti-Alzheimer’s market 97
Cholinesterase inhibitors market analysis 98
Market dynamics 99
Key brands analysis 99
NMDA receptor antagonists 106
Market dynamics 106
Key brands analysis 106
Anti-Alzheimer’s drugs sales forecasts to 2012 109
Epilepsy 110
Market analysis by drug class 110
Competitive dynamics of subclasses of anti-epileptics 111
Leading brands in the anti-epileptic market 112
Traditional anti-epileptics 113
Market dynamics 114
Key brands analysis 114
Second generation anti-epileptics market analysis 120
Market dynamics 120
Key brands analysis 120
Anti-epiletics sales forecasts to 2012 128
Migraine 129
Market analysis by drug class 129
Leading brands of anti migraine drugs 130
Triptans 131
Key brands analysis 132
Anti-migraine sales forecasts to 2012 141
Parkinson’s disease 142
Market analysis 142
Leading brands in the anti Parkinson’s market Table 2.30 summarizes the
performance of the leading anti-Parkinson’s disease brands in 2005-6 143
COMT inhibitors 145
Key brands analysis 146
Dopaminergics 148
Key brands analysis 149
Dopamine Agonists 150
Key brands analysis 151
Anti-Parkinson’s drugs sales forecasts to 2012 158
Schizophrenia 159
Market analysis 159
Leading brands in the Schizophrenia market 161
Typical anti-psychotics 163
Atypical antipsychotics 163
Key brands analysis 164
Schizophrenia drugs sales forecasts to 2012 180
Total CNS disorders’ sales forecasts to 2012 181

Chapter 3 Pipeline analysis 185
Summary 185
Introduction 186
Key trends in R&D 186
New class of drugs 187
Dual mechanism of action 188
Combination drugs 188
New drug delivery formulations 188
The CNS disorders pipeline 190
Leading drugs in development 192
Profiles of key pipeline products 193
Phase II compounds 193
Ketasyn/AC-1202 193
PBT2 (Metal Protein Attenuating Compound) 195
Phase III compounds 197
vilazodone 197
ACP 103 (pimavanserin) 199
MK-0974 202
safinamide 204
Drugs in registration 206
DVS-233 (desvenlafaxine) 206
Trexima (sumatriptan/naproxen) 208
Vimpat (lacosamide) 210
Recently marketed drugs 212
Invega (paliperidone) 212
Neupro (rotigotine transdermal patch) 214
Inovelon (rufinamide) 217
Pipeline forecasts 220
CNS disorders pipeline forecasts 220

Chapter 4 Competitive landscape 223
Summary 223
Introduction 224
Company market shares 224
Johnson & Johnson 228
Overview 228
Sales focus by indication 228
Marketed product portfolio 229
R&D pipeline analysis 231
Strategic and growth analysis 232
Sales and Promotion analysis 232
Drivers of growth 233
Resistors of growth 233
Glaxo SmithKline 234
Overview 234
Sales focus by indication 234
Marketed product portfolio 235
R&D pipeline analysis 237
Strategic and growth analysis 239
Sales and Promotion analysis 239
Drivers of growth 240
Resistors of growth 240
Pfizer 240
Overview 240
Sales focus by indication 241
Marketed product portfolio 242
R&D pipeline analysis 244
Strategic and growth analysis 245
Sales and Promotion analysis 245
Drivers of growth 246
Resistors of growth 246
Lilly 247
Overview 247
Sales focus by indication 247
Marketed product portfolio 248
R&D pipeline analysis 249
Strategic and growth analysis 250
Sales and Promotion analysis 250
Drivers of growth 250
Resistors of growth 251
Sanofi Aventis 252
Overview 252
Sales focus by indication 252
Marketed product portfolio 253
R&D pipeline analysis 254
Strategic and growth analysis 255
Sales and Promotion analysis 255
Drivers of growth 256
Resistors of growth 256
Novartis 257
Overview 257
Sales focus by indication 257
Marketed product portfolio 258
R&D pipeline analysis 259
Strategic and growth analysis 260
Sales and Promotion analysis 260
Drivers of growth 261
Resistors of growth 261
AstraZeneca 262
Overview 262
Sales focus by indication 262
Marketed product portfolio 263
R&D pipeline analysis 264
Strategic and growth analysis 265
Sales and Promotion analysis 265
Drivers of growth 266
Resistors of growth 266
Wyeth 267
Overview 267
Sales focus by indication 267
Marketed product portfolio 268
R&D pipeline analysis 269
Strategic and growth analysis 270
Sales and Promotion analysis 270
Drivers of growth 271
Resistors of growth 271
Forest Labs 272
Overview 272
Sales focus by indication 272
Marketed product portfolio 273
R&D pipeline analysis 274
Sales and Promotion analysis 275
Drivers of growth 275
Resistors of growth 276
Chapter 5 Appendix 279
IMS data 279
N1 Anaesthetics - Includes Anaesthetics local, others 279
N2 Analgesics 279
Index 280

List of Figures
Figure 1.1: Typical treatment patterns in the treatment of Alzheimer’s disease 25
Figure 1.2: Typical treatment patterns in the treatment of MDD 32
Figure 1.3: Typical treatment patterns in the treatment of schizophrenia 38
Figure 1.4: Typical treatment patterns in the treatment of PD 52
Figure 2.5: Global CNS market share by geography, 2006 59
Figure 2.6: Sales of types of CNS disorder brands, 2005-06 60
Figure 2.7: Competitive dynamics of the global CNS market by indication, 2006 64
Figure 2.8: Competitive dynamics of the leading 10 brands in the global CNS market, 2006 67
Figure 2.9: Competitive dynamics of the global anti-depressant market, 2005-6 72
Figure 2.10: Competitive dynamics of the global AD market, 2005-6 96
Figure 2.11: Competitive dynamics of the global AED market, 2005-6 111
Figure 2.12: Competitive dynamics of the global schizophrenia market, 2005-6 160
Figure 3.13: Prevailing R&D approaches, 2006 186
Figure 3.14: The CNS pipeline by indication and stage of development, 2006 190
Figure 3.15: Leading recently launched products and late-stage R&D compounds indicated for the treatment of CNS disorders, 2006 192
Figure 4.16: Competitive dynamics of the leading players in the global CNS market, 2006 227
Figure 4.17: J&J’s CNS portfolio sales by indication, 2006 228
Figure 4.18: GSK’s CNS portfolio sales by indication, 2006 234
Figure 4.19: Pfizer’s CNS portfolio sales by indication, 2006 241
Figure 4.20: Lilly’s CNS portfolio sales by indication, 2006 247
Figure 4.21: Sanofi Aventis’ CNS portfolio sales by indication, 2006 252
Figure 4.22: Novartis’ CNS portfolio sales by indication, 2006 257
Figure 4.23: AstraZenca’s CNS portfolio sales by indication, 2006 262
Figure 4.24: Wyeth’s CNS portfolio sales by indication, 2006 267
Figure 4.25: Forest Labs’ CNS portfolio sales by indication, 2006 272

List of Tables
Table 1.1: Estimated prevalence of CNS disorders across the seven major pharmaceutical markets, 2006 20
Table 1.2: Estimated prevalence of Alzheimer’s disease across seven major markets, 2006 26
Table 1.3: Forecast epidemiology of AD across the seven major markets, 2006-12 27
Table 1.4: Estimated prevalence of MDD across seven major markets, 2006 33
Table 1.5: Forecast epidemiology of MDD across the seven major markets, 2006-12 34
Table 1.6: Estimated prevalence of schizophrenia across seven major markets, 2006 39
Table 1.7: Forecast epidemiology of schizophrenia across seven major markets, 2006 40
Table 1.8: Estimated prevalence of migraine across seven major markets, 2006 44
Table 1.9: Forecast epidemiology of migraine across seven major markets, 2006 45
Table 1.10: Estimated prevalence of epilepsy across seven major markets, 2006 48
Table 1.11: Forecast epidemiology of epilepsy across seven major markets, 2006 49
Table 1.12: Estimated prevalence of PD across seven major markets, 2006 53
Table 1.13: Forecast epidemiology of PD across seven major markets, 2006 54
Table 2.14: Breakdown of the global CNS market by indication, 2002-06 61
Table 2.15: Leading brands in the global CNS disorders market, 2005–06 65
Table 2.16: Breakdown of the global anti-depressant market by drug class, 2002-06 71
Table 2.17: Leading anti-depressant products in the global CNS market, 2005–06 73
Table 2.18: Leading SSRI brands in the global CNS market, 2005–06 75
Table 2.19: Anti-depressants sales forecast, 2006-12 93
Table 2.20: Breakdown of the global anti-Alzheimer’s market by drug class, 2002-06 94
Table 2.21: Leading AD products in the global CNS market, 2005–06 97
Table 2.22: Anti-AD products’ sales forecast, 2006-12 109
Table 2.23: Breakdown of the global Epilepsy market by drug class, 2002-06 110
Table 2.24: Leading AED products in the global CNS market, 2005–06 112
Table 2.25: Anti-epileptics’ sales forecast, 2006-12 128
Table 2.26: Breakdown of the global migraine market by drug class, 2002-06 129
Table 2.27: Leading anti migraine products in the global CNS market, 2005–06 130
Table 2.28: Anti-migraine products’ sales forecast, 2006-12 141
Table 2.29: Breakdown of the global anti-PD market by drug class, 2002-06 142
Table 2.30: Leading brands in the global PD market, 2005–06 143
Table 2.31: Anti-PD products’ sales forecast, 2006-12 158
Table 2.32: Breakdown of the global schizophrenia market by drug class, 2002-06 159
Table 2.33: Leading products in the global schizophrenia market, 2005–06 161
Table 2.34: Schizophrenia products’ sales forecast, 2006-12 180
Table 2.35: CNS market sales forecasts by drug class, 2006-12 181
Table 3.36: CNS disorders pipeline forecasts, 2007-12 220
Table 4.37: Leading players in the global CNS disorders market, 2005-6 224
Table 4.38: J&J’s CNS product portfolio, 2005-6 229
Table 4.39: J&J’s CNS R&D product pipeline, 2006 231
Table 4.40: Promotional spends on major drugs by J&J, 2005-06 232
Table 4.41: GSK’s CNS product portfolio, 2005-06 235
Table 4.42: GSK’s CNS R&D product pipeline, 2006 237
Table 4.43: Promotional spends on major drugs by GSK, 2005-06 239
Table 4.44: Pfizer’s CNS product portfolio, 2005-6 242
Table 4.45: Pfizer’s CNS R&D product pipeline, 2006 244
Table 4.46: Promotional spends on major drugs by Pfizer, 2005-06 245
Table 4.47: Lilly’s CNS product portfolio, 2005-6 248
Table 4.48: Lilly’s CNS R&D product pipeline, 2006 249
Table 4.49: Promotional spends on major drugs by Lilly, 2005-06 250
Table 4.50: Sanofi Aventis’ CNS product portfolio, 2005-6 253
Table 4.51: Sanofi Aventis’ CNS R&D product pipeline, 2006 254
Table 4.52: Promotional spends on major drugs by Sanofi Aventis, 2005-06 255
Table 4.53: Novartis’ CNS product portfolio, 2005-6 258
Table 4.54: Novartis’ CNS R&D product pipeline, 2006 260
Table 4.55: Promotional spends on major CNS drugs by Novartis, 2005-06 260
Table 4.56: AstraZeneca’s CNS product portfolio, 2005-6 263
Table 4.57: AstraZeneca’s CNS R&D product pipeline, 2006 264
Table 4.58: Promotional spends on major CNS drugs by AstraZeneca, 2005-06 265
Table 4.59: Wyeth’s CNS product portfolio, 2005-6 268
Table 4.60: Wyeth’s CNS R&D product pipeline, 2006 269
Table 4.61: Promotional spends on major CNS drugs by Wyeth, 2005-06 270
Table 4.62: Forest Lab’s CNS product portfolio, 2005-6 273
Table 4.63: Forest Lab’s CNS R&D product pipeline, 2006 274
Table 4.64: Promotional spends on major CNS drugs by Forest, 2005-06 275