BNET Focus on Antidepressants: Part 1, Sales and Strategy

(MoneyWatch)  Ever since Eli Lilly launched Prozac in the U.S. in 1987, Americans have had a love affair with anti-depressants. Prozac isn't just a pill. It was the cultural touchstone of 1990s -- as a lifesaver, punchline and punching bag.

When Prozac went off-patent in 2001, something interesting happened: the market for new anti-depressants stayed robust instead of being swept away by cheap generics. Today, branded antidepressants are a $2.4 billion-per-quarter market that is still growing.

This remarkable mix of business, psychiatry and chemistry deserves a closer look. This is the first of three posts in which BNET will look at the state of the branded antidepressant market in the wake of Prozac. Part 1, today, deals with current sales and strategies. Part 2 will look at controversies in the category. And Part 3 will examine the future of the market as more pills head toward generic status.

Second quarter sales of branded antidepressants:

• Effexor XR ... Wyeth ... $1.02 billion
• Lexapro ... Forest Labs ... $583 million
• Cymbalta ... Eli Lilly ... $519 million
• Paxil CR ... GSK ... $253 million
• Total: ... $2.4 billion

The market is essentially divided into two halves: Cymbalta and Effexor vs. Lexapro and Paxil. This is because Cymbalta (pictured) is growing at 26% and Effexor is growing at 5% (off the largest base). By contrast, Paxil sales declined by 18% (in part due to currency exchange bias) and Lexapro's dollar sales were only up a relatively anemic 5.6%, and it is losing share, according to Deutsche Bank.

Now that Paxil has gone generic, GlaxoSmithKline is essentially trying to keep alive a brand that is essentially in a zombie state. What's interesting here is that while generic Paxil is eating Paxil CR alive, Wyeth has essentially the same problem with generic Effexor and Effexor XR and yet has held onto a massive amount of business. This is due in part to Wyeth's successful legal strategy, which held off the appearance of a generic XR version until 2011, and gave Wyeth time to shore up its franchise.

Lilly has been exceptionally aggressive in its promotion of Cymbalta, with heavy spending on a TV advertising campaign, titled "Depression Hurts." Lilly has also pursued new indications for the drug, with has been approved for nerve pain and fibromyalgia.

Forest, meanwhile, has obtained praise from analysts for its ability to keep Lexapro in a favorable position on formularies despite the many generic alternatives available.

The strategic lesson to be learned is that simply launching a new patent-protected pill is not enough. Marketing, legal and formulary strategy must all ride in-sync. Even so, as GSK is currently learning with Paxil, all good things must come to an end.

• BNET Focus on Antidepressants
• Part 1: Sales and Strategy
• Part 2: Controversies
• Part 3: The Future of the Industry