Central Nervous System Drugs on Market, in Labs: a Glossary
Bloomberg News
November 20, 1998, 12:43 p.m. ET
London, Nov. 20 (Bloomberg) -- The following is a partial
list of central nervous system drugs on the market and in
development. The CNS drug market broadly includes those for
depression, psychosis including schizophrenia, dementia including
Alzheimer's disease, Parkinson's disease and other diseases of
the brain or nervous system.
The global CNS market -- the third-largest drug category --
was worth $26.3 billion in the 12 months to July 1998, and was
the fastest-growing of all drug categories, having gained 13
percent in sales from the previous year, according to market
research firm IMS Health.
Lehman Brothers forecasts the CNS drug market will double by
2002 as new drugs are introduced to a market where there is much
room for effective new treatments.
ANTIDEPRESSANTS:
The antidepressant market is dominated by drugs called
selective serotonin reuptake inhibitors (SSRIs), of which Prozac
is the biggest seller. The drugs manage depression in four-fifths
of patients, but also can depress sexual drive and cause
insomnia. Newer drugs which claim fewer side effects, such as
American Home Products Corp.'s Effexor and Akzo Nobel NV's
Remeron, are making inroads into that market.
The market for antidepressants in the U.S. was worth about
$6.5 billion in 1997 and grew at about 14% in the year to August,
according to IMS.
SSRIs:
Prozac (fluoxetine), by Eli Lilly. The biggest-selling SSRI, with
about 19 percent of U.S. depression market, generating $2.59
billion in 1997.
Zoloft (sertraline), Pfizer. Second-biggest U.S. SSRI. Sales of
$1.5 billion in 1997, or 16 percent of U.S. market. Approved for
depression, obsessive compulsive disorder and panic disorder.
Paxil/Seroxat (paroxetine), SmithKline Beecham. Third-biggest
SSRI. Sales of $1.47 billion in 1997. Approved for panic
disorder, approved for social phobia only in UK. Drug developed
by Novo Nordisk A/S.
Cipramil/Celexa (citolopram), H Lundbeck A/S (privately held
Danish drug company). Approved in 65 countries, market leader in
some European countries. Launched in USA through Forest
Laboratories Inc. and Warner-Lambert Co. last summer. Growing
strongly.
Serotonin Noradrenaline Reputake Inhibitor (SNRI):
Effexor, Efexor XR (venlafaxine), American Home Products (Wyeth-
Ayerst division). Now has about 4 percent of U.S. market. First
launched in 1994 and the first of this new class of drugs. Efexor
XR, a once-daily formulation, first marketed in 1997. Sales of
$430 million in 1997.
Ixel (milnacipran), Pierre Fabre Medicament SA.
Serzone/Dutonin (nefazodone), Bristol-Myers Squibb. Launched in
1995. Now has 3 percent of US market. Also blocks 5-HT receptor,
which affects course of depressive illness.
Noradrenaline reuptake inhibitors (NARI):
Edronax (reboxetine) Pharmacia & Upjohn Inc. Marketed in some
European countries. Application pending in U.S. Blocks only
noradrenaline, a brain chemical.
Noradrenergic and Specific Serotonergic Antidepressant (NaSSA):
Remeron (mirtazapine) Akzo Nobel NV's Organon drug division.
Marketed in the U.S. and elsewhere. Sales of $88.7 million in
1997.
Older, off-patent antidepressants and antianxiety drugs:
Benzodiazepines: Valium, Xanax, etc. Approved for anxiety.
Previously widely used for depression.
Tricyclics:
Imipramine, amitriptyline, others.
DEMENTIA and ALZHEIMER'S DISEASE:
These related diseases affect an estimated 18 million people
worldwide -- about one in every 20 people over 65 -- causing
memory loss, deteriorating mental function and other symptoms.
The affected population could grow to 34 million people by 2004
as populations age, said the London-based Alzheimer's Disease
Society.
The cost of care averages about $25,000 a year per patient.
More than 100,000 deaths a year are attributed to Alzheimer's in
the U.S., the fourth-commonest cause of death. The world market
for treating Alzheimer's disease was worth about $2 billion in
1997 and is expected to grow rapidly as new treatments are
approved and adopted, according to DataMonitor, a U.K. consulting
firm.
Acetylcholinsterase inhibitors:
A major area of Alzheimer's research. Alzheimer's patients
have lower levels of a brain chemical called cholinesterase.
Acetylcholinesterase inhibitors seek to block the enzyme that
breaks down this chemical.
Cognex (tacrine), Warner-Lambert. The first of this new class of
drugs. However, liver toxicity slows sales, particularly since
introduction of Aricept.
Aricept (donezepil), Pfizer/Eisai. Approved in U.S. and
elsewhere, launched in Jan. 1997. The biggest-selling Alzheimer's
drug. Generated $263 million in the first nine months of 1998,
double the same period a year ago. J.P. Morgan forecasts sales of
$525 million in 2000.
Exelon (rivastigmine), Novartis. Recently approved in Europe and
more than 30 countries worldwide. The FDA turned down the drug
pending additional studies several months ago.
Reminyl (galantamine), Shire Pharmaceuticals Plc/Johnson &
Johnson. Made from daffodil extracts. Now in Phase 3 clinical
trials.
Synapton (Forest Labs). FDA in November notified the company that
it wouldn't approve the drug.
Glial Cell Modulator:
Viviq (propentofylline), Hoechst. Filed for approval in Europe,
Canada and USA in 1998. European regulators turned down drug Oct.
20 but company said it would probably appeal the decision this
month. Hoechst said it has no plans to drop drug. It has forecast
peak annual sales of 750 million deutsche marks ($420 million).
Bilarcil (metrifonate), Bayer. Company said in September it had
suspended all eight clinical trials of the drug after 20 patients
of the 3,000 taking the medication developed ''muscle weakness.''
Bayer estimated the drug could have peak annual sales of 900
million marks. Company says it still plans to continue
development of drug. Application for approval sought from FDA and
other agencies in late 1997.
Muscarinic Agonists:
Xanomeline. Eli Lilly dropped development of the drug this year
due to ''a lack of clinical efficacy.''
Memric (SmithKline): Drug dropped from clinical development in
1998.
SCHIZOPHRENIA:
Affects about 1 percent of population, causing so-called
''positive'' symptoms, such as hallucinations and delusions, and
''negative'' symptoms, such as emotional and social withdrawal.
About a quarter of all hospital beds in developed countries
are occupied by schizophrenics, making the development of
effective new treatments a major priority for both pharmaceutical
companies and mental-health experts.
For years, the main treatments were Clozapine (Novartis) and
more recently Risperdal from Johnson & Johnson.
Risperdal (risperidone), Johnson & Johnson. Launched in 1993,
biggest selling antipsychotic in US.
Zyprexa (olanzapine), Eli Lilly. Now the second-biggest and
fastest-growing schizophrenia drug in the U.S. with 17% of the
market.
Clozaril (clozapine), Novartis. Effective but has side effects.
Nipolept/Zoleptil (zotepine), BASF AG. Available in some European
countries, not in U.S.
Haldol (haloperidol), off-patent, sold by Johnson & Johnson and
others. Fourth-biggest seller in US, with 11 percent of market.
Zeldox (ziprasidone), Pfizer. Rejected by FDA in June. Pfizer
plans to submit more data to agency. J.P. Morgan forecasts sales
of $175 million in 2002.
Seroquel (quetiapine), Zeneca. Launched in US, elsewhere. Slower-
than-expected growth.
Serlect/Serdolect (sertindole), H. Lundbeck. Approved in Europe
except France. Licensed in U.S. to Abbott Laboratories, which is
conducting more tests.
--Dane Hamilton in the London newsroom (44-171) 330-7727/ab |
