Treatment-Resistant Depression Treatment Market Size, Share & COVID-19 Impact Analysis, By Drug Type (N-methyl-D-aspartate (NMDA), Antidepressants, Antipsychotics, and Others), By Distribution Channel (Hospital Pharmacies, Drug Stores & Retail Pharmacies, and Online Pharmacies), and Regional Forecasts, 2023-2030

The treatment-resistant depression treatment market size was valued at USD 1.71 billion in 2022 and is projected to grow from USD 1.95 billion in 2023 to USD 4.06 billion by 2030, exhibiting a CAGR of 11.0% during the forecast period (2023-2030). North America accounted for a market value of USD 0.94 in 2022.

Treatment-Resistant Depression (TRD) is a type of Major Depressive Disorder (MDD), which occurs after inadequate response to at least two antidepressants during the treatment process. Several factors, such as abnormal neural activity, melancholic clinical features, inflammatory system activation, bipolarity, neurotransmitter dysfunction, and a higher traumatic load, are associated with this disorder. There are various treatment approaches for this mood disorder, such as monotherapy (antidepressants) and polytherapy. 

In polytherapy, various drugs and drug classes are given to treat this mood disorder, such as the combination of two different antidepressants and the combination of antidepressants with antipsychotics, among others. The treatment-resistant depression treatment market growth is accredited to the prompt upsurge in the prevalence of this mood disorder and the necessity to defend the individual's life from suicide. Furthermore, many players emphasize the research and development activities to develop inventive drugs to treat this mood disorder, which is predicted to increase the demand for its treatment during the forecast period.                              

COVID-19 IMPACT

COVID-19 Affirmatively Affected Market Revenue Due to Increased Incidence of Depression 

The coronavirus pandemic has resulted in a remarkable demand for healthcare. The occurrence of COVID-19 cases has created global worries related to multiple psychiatric problems. A substantial rise in treatment-resistant depression treatment has been observed during the pandemic, which is attributable to the increased incidence of this disorder during the lockdown and the high risks of suicides among patients. Furthermore, the pandemic has also elevated awareness and reduced the stigma surrounding mental health treatment, which increased the demand for its treatment.

For instance, according to the study published by Elsevier Inc. in October 2021, rates of depression climbed by around 28.0% in 2020 due to the effect of the COVID-19 pandemic. Such an increased rate of this disorder led to a rise in the incidence of this disorder during the pandemic.

Various market players and government-funded research institutes initiated drug development projects for this disorder through research grants to exploit the potential candidates under development. This is leading to the introduction of novel products for treatment during the forecast period.

Furthermore, the market players witnessed an increase in the revenue of drugs generated during 2020. For instance, H. Lundbeck A/S's Lexapro registered a growth of 9.7% in 2020 from 2019 due to increased engagement of healthcare professionals to treat a broad range of psychiatric diseases.

LATEST TRENDS

Transition from Oral to Other Routes of Administration to Aid Market Growth

The rising incidence of the disorder and increasing emphasis on early diagnosis and management has led to rising awareness among general population towards available treatment options. This is further facilitated by increased their focus by market players on the development and introduction of novel route of administration for the administration of drugs.

The traditional antidepressants typically take 4-6 weeks to exhibit their effects when administered orally, with the risk of incomplete or inadequate outcomes. In contrary, the intranasal has shown better results within hours of administering the drug.

• For instance, according to an article published by Pharmacopsychiatry in January 2022, reported that Novartis Pharmaceuticals' novel antidepressant MIJ821 demonstrated a significant reduction in depressive episodes within 24 hours of weekly intravenous administration among patients. 

The overall findings indicated that the combination of intranasal esketamine with a new oral antidepressant was more effective than a placebo combined with oral administration. Intranasal esketamine resulted in a rapid reduction in depressive symptoms and delayed relapse.

Such growing research & development for advanced routes of administration is expected to increase the demand for drugs, thereby boosting the overall market growth.

TREATMENT-RESISTANT DEPRESSION TREATMENT MARKET GROWTH FACTORS

Growing Prevalence of the Condition Globally to Drive Market Growth

Rising burden of treatment-resistant depression is one of the most critical drivers that positively impact the market's growth. Treatment-resistant depression is a condition stated when a patient has not shown any positive response to the two different antidepressants taken for at least six weeks. The increase in the burden of this disorder has surge the demand for treatment-resistant depression treatment.

The prevalence is also associated with significant rise in the healthcare costs including direct and indirect costs greatly straining healthcare systems in various countries. The diversity in the type of healthcare setting and varying access to high-quality healthcare services across countries contribute to increasing demand for effective therapeutic measures.

These factors have been pivotal in rising awareness among general and patient population towards the available treatment and management options of the condition, especially in emerging countries. This is expected to increase the demand for the drugs and foster the overall market growth.

Growing Drug Development Activates By Major Players to Boost Market Growth

The rising cases of treatment-resistant depression, and limited options for management have increased the focus of market players to start R&D projects. Several primary market players are putting their focus on the development of new and innovative therapies, recognizing the clinical benefits and a major unmet demand to treat the disorder across the globe. 

• For instance, in August 2022, it was reported that GH Research invested USD 4.2 million in Q2 of 2022 compared to USD 2.0 million in Q2 of 2021. The increase was due to increased activities related to clinical trials and employee expenses to support these activities. The company's lead pipeline candidate, GH001, completed Phase 1 and Phase 1/2 clinical trials in patients with TRD.

It is a major cause of disability worldwide, as conventional treatments are ineffective for a large patient population and new treatments are needed to meet this growing demand. Several life science and pharmaceutical companies are investing actively in the clinical trials of potential candidates to launch new therapeutic drugs.

• In February 2022, Denova Biopharma secured U.S. FDA approval to initiate a Phase 2b clinical trial to analyze the serotonin and safety of db104 liafensine in patients with a treatment-resistant mood disorder.

This active participation of private and public players in the development of potential candidates in research will increase the demand for the treatment across the world.

RESTRAINING FACTORS

Lack of Standard Guidelines for the Management of Disorders to Limit Market Growth

Despite the surge in the investment from companies operating in the market for the development of an effective therapeutic, this disorder of the mood is poorly managed, leading in variations in how patients suffering from this disorder are managed in real-world practice.

Furthermore, lack of standard guidelines in diagnosing patients is another challenge for the treatment of this disease. Patients discontinue treatment or drop out the treatment due to no or poor outcomes. Moreover, lack of therapeutic options, inadequate guidelines for managing patients, and social and cultural stigma for recording the non-responsiveness to treatment, are some of the factors responsible for hindering market growth.

• As per the study by the study published by NIH in December 2020 for the management of TRD, there are about 41% physicians who reported the loss to follow-up and discontinuation of treatment as one of the main challenges. In addition, lack options in therapeutics was reported to the biggest challenge which was encountered by 15% of the physicians. Other 13% and 14% were related to the specific rules and guidelines for managing the condition and poor standardized definitions.

Hence, limited emphasis on established guidelines for management of the condition, combined with comparatively lower number of drugs being approved by regulatory authorities have limited the adoption of drugs.

SEGMENTATION

By Drug Type Analysis

NMDA to Expand at Highest CAGR due to Launches of Pipeline Drugs during the Forecast Period

Based on drug type, this market is segregated into N-methyl-D-aspartate (NMDA), antidepressants, antipsychotics, and others.

The antidepressants segment is anticipated to dominate the treatment-resistant depression treatment market share during the forecast period. The large share of the segment is due to the growing occurrence of this mood disorder, which is projected to raise the demand for antidepressant drugs, such as serotonin and norepinephrine reuptake inhibitors (SNRIs) and Selective serotonin reuptake inhibitors (SSRIs) across the world. This is further augmented by the rise in

The N-methyl-D-aspartate (NMDA) segment is predicted to expand at the highest growth rate during the forecast period. The growth is due to the increasing research studies for developing NMDA drugs to improve treatment outcomes. Moreover, the high prevalence of this disease and the FDA approval of NMDA drugs developed by key companies are anticipated to boost the growth of the segment during the forecast period.

• For instance, in March 2021, Janssen Global Services, LLC announced U.S. FDA approval of SPRAVATO (esketamine) Nasal Spray for Adults with Treatment-Resistant Depression. Such approvals are expected to stimulate other market players for the R&D of NMDA drugs, thereby spurring segmental growth during the forecast timeframe.

By Distribution Channel Analysis

Hospital Pharmacies to Continue its Dominance Owing to Increased Patient-Visit to Hospitals 

Based on distribution channel, the market is categorized into hospital pharmacies, drug stores & retail pharmacies, and online pharmacies.

In 2022, the hospital pharmacies segment dominated the market and is projected to expand at a significant CAGR during the forecast period. The crucial factor attributing the segment growth is that a prescription from a medical professional is needed for drugs for the treatment. Furthermore, expanding hospital pharmacies owing to increasing investment in the healthcare infrastructure by the public sector in developing countries is anticipated to boost segmental growth during the forecast period.

The drug stores & retail pharmacies segment is expected to expand at a moderate CAGR during the forecast period, 2023-2030. The growth is due to increasing patient demand, increased drug stores & retail pharmacies, and augmented capitalization by governments and other establishments to improve retail pharmacies.

The online pharmacies segment is anticipated to expand at the highest CAGR during the forecast timeframe. The segment's growth is due to the surging launch of online pharmacies. Furthermore, the growing investment in online pharmacies is expected to propel segmental growth in the forecast timeframe.

REGIONAL ANALYSIS

Geographically, the market is studied across North America, Europe, Asia Pacific, and Rest of the World.

North America dominated the global market with a share of 54.97% in 2022 and is anticipated to remain dominant during the forecast period. The growth is attributed to the increasing patient population suffering from treatment-resistant depressive disorder. Additionally, the growth of the treatment resistance depression treatment at the American Psychiatric Association linked institutions and other healthcare facilities. Furthermore, the rising number of guidelines and approval of drugs for treatment in the region is projected to drive market growth across North America.

Europe held the second-highest market share in 2022 and is anticipated to expand at a substantial CAGR during the forecast period. The significant R&D investment and increasing focus of market players to introduce drugs in the region is anticipated to increase the demand for treatment-resistant depression treatment during the forecast period.

The market across Asia Pacific is predicted to expand at a moderate CAGR during the forecast period. The CAGR of the region is attributed to the rising awareness related to the treatment of this mood disorder integrated with its increasing prevalence.

• For instance, according to a study published in the Indian Journal of Private Psychiatry in 2019, the estimated treatment-resistant depression occurs in 10–30% of patients with MDD.

The rest of the world is estimated to develop at a relatively decreased CAGR during the forecast period. The growth is due to the surging healthcare expenditures and rising incidence of mood disorders.

KEY INDUSTRY PLAYERS

Diversified Antidepressant Drug Offerings by Chief Players to Spur Market Growth

Eli Lilly and Company, Pfizer Inc., and GlaxoSmithKline plc are some of the top players in the market with a strong brand existence combined with drug offerings in diversified segments, including antipsychotics and antidepressants for treatment. The companies are emphasizing investments in research and development activities to launch effective and highly advanced drug classes to treat this disorder. Furthermore, a strong focus on tactical mergers with other companies & several research organizations to develop effective treatment options is expected to support the expansion of these companies in the future.

Other players involved in treatment-resistant depression treatment include AbbVie Inc., Janssen Global Services, LLC, H. Lundbeck A/S, Sandoz International GmbH (Novartis AG), Otsuka Pharmaceutical Co., Ltd., Par Pharmaceutical (Endo International plc), AstraZeneca, and others.  These companies emphasize business expansion through strategic acquisition and collaborations with market players to upscale their R&D activities.

LIST OF KEY COMPANIES IN TREATMENT-RESISTANT DEPRESSION TREATMENT MARKET:

• Eli Lilly and Company (U.S.)


• GlaxoSmithKline (U.K.)


• Pfizer Inc. (U.S.)


• Janssen Global Services, LLC (Johnson & Johnson Services, Inc.) (Belgium)


• AbbVie Inc. (U.S.)


• AstraZeneca (U.K.)


• H. Lundbeck A/S (Denmark)


• Sandoz International GmbH (Novartis AG) (Germany)


• Par Pharmaceutical (Endo International plc) (India)


• Otsuka Pharmaceutical Co., Ltd. (Otsuka Holdings Co., Ltd.) (Japan)

KEY INDUSTRY DEVELOPMENTS:

• January 2023 - GH Research announced the initial approvals received for the Phase 2b trial of GH001 in TRD (GH001-TRD-201), and the company is expected to complete initiation of the trial in Q1 of 2023.


• August 2022 - Merck Sharp & Dohme LLC’s MK-1942 entered Phase IIa. The primary aim is to evaluate and established the efficacy and safety of the drug among patients with treatment-resistant depression disorder.


• July 2022 - Novartis Pharmaceuticals announced that it would start a Phase II clinical trial of MIJ821 for treatment-resistant depression disorders in 2022.


• December 2021 - GH Research announced successful outcomes of the Phase 1/2b clinical trial of GH001, an inhalable 5-MeO-DMT product candidate, for treatment-resistant depression treatment.


• September 2021 - Perception Neuroscience initiated Phase IIa clinical study to evaluate the safety and efficacy of PCN-101 (R-ketamine) for treatment-resistant depression treatment.

REPORT COVERAGE

The global market report analysis includes a detailed competitive landscape, market trends, market insights, and market drivers. It focuses on key aspects such as the prevalence of TRD, regulatory scenarios by key countries/regions, and an overview of current advances in R&D for drugs in the market. Furthermore, the report provides information on key industry developments and detailed pipeline analysis. In addition, the report includes insights related to the impact of COVID-19 on the market.

Report Scope & Segmentation

ATTRIBUTE	DETAILS
Study Period	2019-2030
Base Year	2022
Estimated Year	2023
Forecast Period	2023-2030
Historical Period	2019-2021
Unit	Value (USD billion)
Growth Rate	CAGR of 11.0% from 2023-2030
Segmentation	By Drug Type N-methyl-D-aspartate (NMDA) Antidepressants Antipsychotics Others
By Distribution Channel Hospital Pharmacies Drug Stores & Retail Pharmacies Online Pharmacies
By Geography North America (U.S. and Canada) Europe (Germany, U.K., France, Italy, Spain, and the Rest of Europe) Asia Pacific (China, India, Japan, Australia, and the Rest of Asia Pacific) Rest of the World