Abilify is the Most Commonly Prescribed Antipsychotic Drug Among Newly Diagnosed Bipolar Disorder Patients in the United States

BURLINGTON, Mass., Oct. 23, 2014 /PRNewswire/ -- Decision Resources Group finds that, through analysis of U.S. longitudinal patient-level claims data, Abilify (Bristol-Myers Squibb/Otsuka) 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.

Other key findings from the report entitled Treatment Algorithms in Bipolar Disorder:

• Patient share for Lamotrigine in first three lines: Lamotrigine (GlaxoSmithKline's Lamictal, 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, 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, Latuda's (Sumitomo Dainippon Pharma/Sunovion/Takeda) patient share has increased markedly from Q4 2012 to the Q4 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.

Comments from Decision Resources Group Principal Business Insights Analyst Natalie Taylor, Ph.D.:

• "Bipolar depression occurs more frequently than mania and this stage is challenging to treat, especially in patients suffering from a combination of depression and hypomanic symptoms. Lamotrigine continues to be one of interviewed thought leaders' preferred agents for treating bipolar depression and as a maintenance therapy to prevent future depressive episodes, a preference that is underscored by these data. Therefore, it is not surprising that lamotrigine is among the most common monotherapy and combination therapies for first-line treatment.
• "Trends in newly-diagnosed patients suggest a decline in antidepressant use to the likely benefit of the atypical antipsychotics, due to antidepressants' lack of efficacy and their risk of triggering mania when used for treating bipolar disorder. In particular, use of SNRIs has dropped significantly; fewer patients are receiving Cymbalta (Eli Lilly)—though with the generic entry of duloxetine in December 2013, at the very end of our study period, we expect a switch to generic duloxetine products. These trends are likely due an increasingly restrictive reimbursement environment, further fragmenting the market."

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