Stakeholder Insight: Anxiety Disorders - More Than Just a Comorbidity

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