Antipsychotic Drugs: An Overview of Their Usage, Side Effects, and Impact on Business
Usage of Antipsychotic Drugs
Antipsychotic Drugs, also known as neuroleptics or major tranquilizers, are a class of medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), principally in schizophrenia and bipolar disorder. These medications are often used to treat schizophrenia, schizoaffective disorder, and acute episodes of mania or mixed episodes associated with bipolar disorder. Some typical and atypical antipsychotics are also prescribed for off-label use for conditions like agitation, insomnia, anxiety, depression, and post-traumatic stress disorder (PTSD).
First Generation vs Second Generation Antipsychotics
Antipsychotic Drugs are broadly divided into two categories - first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs). FGAs, also called typical antipsychotics, were discovered in the 1950s and were the first drugs approved for treating psychosis. Some examples include chlorpromazine, haloperidol, fluphenazine, and thioridazine. SGAs, also called atypical antipsychotics, were developed later in the 1980s and 1990s. They are thought to have fewer side effects than FGAs. Some commonly used SGAs include clozapine, risperidone, olanzapine, quetiapine, aripiprazole, and ziprasidone. While FGAs are effective for positive symptoms like hallucinations and delusions, SGAs can impact both positive and negative symptoms as well as reducing the risks of extrapyramidal side effects and tardive dyskinesia.
Common Side Effects of Antipsychotic Medications
Like all medications, antipsychotic drugs can cause side effects, though not everyone experiences them. Common side effects varies between FGAs and SGAs but may include dry mouth, headache, dizziness, nausea, constipation, blurred vision, weight gain, diabetic control issues, elevated prolactin levels, sedation, restlessness, insomnia, and sexual dysfunction. Muscle spasms, painful muscular twitches, tremors, muscle stiffness or rigidity are examples of extrapyramidal side effects seen more frequently with FGAs. Tardive dyskinesia, a potentially permanent movement disorder characterized by involuntary twitching and repetitive movements, can occur rarely due to long-term FGA usage, which is less common with SGAs. Managing and monitoring side effects closely with the doctor is important for successful treatment.
Rising Costs and Impact on Businesses
Antipsychotic drugs represent significant health care costs. The annual cost of therapy ranges from thousands to tens of thousands of dollars per patient depending on the medication, dosage and duration of treatment. Spending on antipsychotics has increased substantially in recent years, making it one of the highest cost therapeutic classes. According to a 2009 study, direct spending on antipsychotic medicines was around $18 billion. The healthcare costs borne by businesses for employees taking these medications has also increased substantially.
Indirect costs like lost work time, reduced productivity and disability claims further escalate the total cost burden on employers. Psychiatric conditions like schizophrenia are among the most disabling, with non-adherence to treatment being common. This hampers the individual's social and occupational functioning, reducing their ability to maintain steady employment. Providing ongoing healthcare coverage and workplace accommodations for employees undergoing antipsychotic treatment adds to business expenses.
Generics Help but Branded Drugs Dominate Sales
While the availability of inexpensive generic versions of older antipsychotics has helped contain costs to some degree, patents on newly introduced SGAs are still in effect. As a result, the latest branded drugs retain a major market share and fetch much higher prices compared to generics. For instance, in 2019 the top 4 selling antipsychotics in the US were all branded - Abilify, Rexulti, Vraylar and Latuda. Together they raked in over $7.5 billion in sales. As these drugs go off-patent in future, market entry of lower cost generics is expected to significantly curb spending. However, pharmaceutical companies continue launching new patented antipsychotics to protect revenues.
Impact on the Pharmaceutical Industry
The global antipsychotic drugs industry size was estimated at $16.8 billion in 2020. It is anticipated to witness a compound annual growth rate of over 4% and surpass $21 billion by 2026. North America currently dominates accounting for around 40% global sales, followed by Europe and Asia Pacific. The large patient pool and increasing healthcare spending makes antipsychotics a highly lucrative segment for pharmaceutical firms. All major pharma players have a strong antipsychotic product portfolio. Developing innovative novel mechanisms and indications, as well as filing for longer patent extensions, are key strategies adopted to gain market share. Generic drug makers also ramp up production of off-patent antipsychotics to cater growing demand. Overall, antipsychotic drugs will remain a mainstay of pharmaceutical business growth prospects in the years to come. However, managing costs will be crucial for healthcare sustainability.
In antipsychotic medications play an important role in treating mental illnesses despite their side effects and high costs. Pharma companies continue to develop new and improved drugs while generics help contain expenditures. Businesses also shoulder substantial indirect expenses due to lost productivity from untreated illnesses. Effective management strategies are needed across stakeholders to achieve treatment goals without overburdening healthcare systems.
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Ravina Pandya, Content Writer, has a strong foothold in the market research industry. She specializes in writing well-researched articles from different industries, including food and beverages, information and technology, healthcare, chemical and materials, etc. (https://www.linkedin.com/in/ravina-pandya-1a3984191)
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