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Top 12 Selling Psychiatric Drugs: United States

Research firm IMS Health has been collecting data on the number of prescriptions filled for certain drugs as well as the top selling drugs. The data that they collected was from July 2013 to June 2014; a full 12 months. From the lists of the top 100 drugs, I’ve narrowed it down to drugs that are specifically used for psychiatric purposes. There are some discrepancies between the drugs that are most heavily prescribed and the ones with the largest profit margins.

The evidence below suggests that marketing is going a long way to promote drugs. The drugs that are most heavily marketed seem to have some of the largest profits. Additionally drug companies are marketing their drugs as aggressively as possible trying to simply maximize profits.

Top Selling Psychiatric Drugs

Below is a list and brief description of the drugs yielding the biggest profits from July 2013 to June 2014. Keep in mind that the data collected may not be 100% accurate, but these are relatively good estimates.

1. Abilify ($7,240,043,661)

If I asked you how much money Otsuka America made off of their atypical antipsychotic drug over the past 12 months, what would you guess? Probably not 7.24 billion dollars. This is a drug that was initially approved to treat schizophrenia, then bipolar disorder, but since has been approved as an augmentation strategy for depression as well as irritability among those with autism. This was the drug with the largest profits out of any drug in the United States and ranked #1 overall against the field.

2. Cymbalta ($2,839,722,673)

This drug ranked #17 overall in terms of profits for the past year. Although this is the most prescribed psychiatric drug of the past 12 months, it is not the one pulling in the biggest profits. A lot of this has to do with the fact that in comparison to Abilify, the cost per pill is greater. This is because for 30 capsules of Cymbalta, a person is paying just shy of $300 whereas 30 capsules of Abilify a person is paying $1000.

3. Lyrica ($2,782,036,977)

Overall, this drug came in at #19 for profits throughout the past year. It is an anticonvulsant drug that is utilized mostly to treat neuropathic pain. In some cases it is used as treatment for partial seizures and in Europe it is approved for generalized anxiety disorders.

This drug has been aggressively marketed from its initial release and the company Pfizer was fined $2.3 billion by the Department of Justice as a result of promotion for off label purposes. In 2010, sales of this drug exceeded $3 billion, but it still is in the top 20 for overall sales.

4. Vyvanse ($1,940,313,035)

The new and improved “pro-drug” of Adderall has been raking in the profits. The drug is made by Shire and just from profits the past year, the company pulled in nearly $2 billion. Overall the drug was ranked #28 on the list of top 100 for profits this past year.

I expect this drug to continue to perform well as it is essentially a less powerful version of Adderall with less side effects. Additionally it may end up getting approved to treat other conditions besides ADHD. As someone who has had to fill a prescription for Vyvanse without insurance, I know how costly it can be; over $200 for 30 capsules.

5. Namenda ($1,774,338,290)

The first novel Alzheimer’s disease medication that works on NMDA receptors within the glutamatergic system performed well in sales. It ranked as the #33 drug in terms of overall sales, and came in fifth for psychiatric medications. It is marketed by Forest and has been shown to provide significant improvement in those with moderate and/or severe Alzheimer’s disease as well as dementia.

This is a drug that can run a person over $300 for a 30 day supply; pretty expensive. The “XR” (extended release) version of this drug is also very popular.

6. Suboxone ($1,388,999,843)

This is a narcotic analgesic medication that is used primarily for opioid replacement therapy. People that are addicted to drugs like heroin, painkillers, and other opiates can quit their drug and transition to Suboxone. This transition allows for people to avoid severe opiate withdrawal and increase the chances of a smoother withdrawal experience.

Suboxone came in ranked #38 overall of the top 100 for sales. This drug is also used to treat moderate chronic pain. In some cases, people are even experimenting with Suboxone for depression as an off-label treatment; this is typically reserved for former opioid addicts.

7. Seroquel XR ($1,266,841,322)

The atypical antipsychotic Seroquel came in seventh on the list of psychiatric drugs and ranked #41 overall for sales. If we are talking worldwide sales, this drug typically pulls in over $5 billion a year. The drug was developed by AstraZeneca and this “XR” version is a version that provides symptom relief for 24 hours.

It is primarily used to treat schizophrenia, but has since been approved for bipolar disorder as well as to serve as an adjunct treatment for those with major depression. Sometimes it is prescribed for Parkinson’s disease, Alzheimer’s disease, and insomnia. Although it is pretty ridiculous that such a powerful drug is sometimes handed out for insomnia and even depression, this is how drug companies rake in such big profits.

8. Invega Sustenna ($891,518,099)

Invega Sustenna is a long-acting injectable drug that is used to treat mania, bipolar disorder, and schizophrenia. The reason this drug is pulling in the profits has to do with convenience. People don’t need to remember to pop a pill every day, they can simply get an injection once per month and not worry about it. The sales ranked #67 overall, but it was eighth overall for psychiatric drugs. This drug is the primary active metabolite of the older medication risperidone (Risperdal).

9. Latuda ($803,311,039)

When a new drug comes out, doctors and patients flock to the medication because they believe newer always equals better. The drug Latuda was recently approved by the FDA and is the newest atypical antipsychotic drug on the market. It ranked #77 overall for sales, but cracked the top 10 for psychiatric drugs.

It was developed by the company Dainippon Sumitomo Pharma and marketed by Sunovion in the United States. It has been approved for schizophrenia as well as depressive episodes associated with type-1 bipolar disorder. As this drug gets approval to treat other conditions such as major depression, sales will continue to climb.

10. Lunesta ($778,412,409)

This is still one of the top drugs for insomnia and one of the best marketed. It ranked #79 overall for sales, but tenth for psychiatric drugs. This drug is marketed by Sunovion and it works as a nonbenzodiazepine hypnotic, which has been proven effective for insomnia.

As cases of stress and insomnia continue to spike in the United States, more people turn to “Z-drugs” or sleep drugs as a way to cope with their problem. Most cases of insomnia would be better addressed through natural means, but people like easy – so they continue buying Lunesta.

11. Pristiq ($687,192,710)

Pristiq is a synthetic form of the major active metabolite of the drug Effexor. It is an SNRI drug that is used to treat depression. For a 30 day supply of this drug, you can expect to pay over $200. Many doctors are switching people from Effexor to Pristiq – in part this is due to the drug potentially having less side effects. However, in large part, the switch from Effexor to Pristiq has to do with profits.

A person can get a 30 day supply of Effexor for under $30 whereas a person on Pristiq is paying top dollar for a self-proclaimed (by Wyeth) better version of the drug. Essentially this is a patent-extended for Wyeth with theoretically a superior drug, but patient responses aren’t as promising. This drug comes in ranked #89 overall for sales and if it gets approved for non-hormonal menopause treatment, expect profits to increase.

12. Strattera ($658,818,959)

The norepinephrine reuptake inhibitor (NRI) drug that is Strattera comes in ranked number twelve on the list of psychiatric drugs. In the top 100 drug profits of the past year, it was ranked #93. It is considered a non-addictive medication to treat ADHD. Many doctors like it because it has been approved in all people over the age of 6 and has less of a withdrawal than other drugs like Adderall, Vyvanse, and Ritalin.

This is a different type of medication and since it’s unique, expect prescriptions to hold steady for Strattera. If it gets the nod to be prescribed for major depression (or cases of depression with co-morbid ADHD), expect sales to further rise (read: Strattera for depression). Other uses for this drug that haven’t been approved include: weight loss, bedwetting, and binge eating.

My thoughts on top selling psychiatric drugs of 2013

This day in age, the top selling drugs are a product of aggressive marketing, treating multiple conditions, doctor incentives, high costs, and brainwashing the general public. It nearly makes me sick to my stomach to see Abilify take the cake for largest profits of the year. This is a very powerful psychiatric drug that is being prescribed for off-label purposes in many cases simply so that money can be made.

  • New drugs – Many of the drugs on this list are “new.” Regardless of whether they are improved, have less side effects, etc. people are going to try them simply because they are new and flashy. Additionally, many are thought to be improved versions of older drugs.

  • Multi-purpose approvals – Drugs that have been approved to treat more than one condition are the ones that tend to rake in the most money. Take Abilify for example… it is approved to treat schizophrenia, bipolar disorder, depression, and irritability. This increases the potential customer-base.

  • Aggressive marketing – Drugs these days are subject to aggressive marketing. Banners on the streets, advertisements online, and the worst culprit of them all, TV commercials. The marketing makes the drug look like it will solve all problems.

  • Doctor incentives – Although you may not know it, some doctors are given incentives and/or “bonuses” to prescribe certain drugs over others. If they fill a certain amount of prescriptions per month, they get a reward.

  • Public brainwashing – Eventually the general public becomes brainwashed by advertising, their doctor, and the fact that a drug is new and they think it’s going to be amazing. This is why it’s so common for people to think that Abilify is an antidepressant rather than an antipsychotic.

  • High costs – Once there’s a market for these drugs, the companies can charge top dollar for their drugs. As long as people keep paying for the drugs, the pharmaceutical companies are making bank.

Although it was approved and is effective for treating a variety of conditions, people fail to understand the true power of antipsychotic drugs; these can cause permanent changes in the brain and nervous system. Unless you are on it for schizophrenia or bipolar disorder, personally I don’t think the stuff should be used. This was one of the most aggressively marketed drugs of the past few years. Abilify commercials on TV, posters, Google advertisements, etc.

Most of the brainwashing came when people who suffered from major depression became convinced that they needed this drug. The bulk of depression treatments on the market aren’t that good, but throwing this powerful drug into the mix should only be done out of sheer desperation. Seroquel is like an older version of the drug which provides the consumer with something different.

I expect Latuda to have a lot of potential for profits once it gets approved for other conditions. Invega Sustenna in the form of monthly injections has a lot of potential as well. People brought to hospitals may simply be given these injections as a way to tranquilize those with mental illness.

Although all of these drugs can be helpful when used for the intended purpose, it’s the off label purposes and prescriptions by doctors just to increase profits that is scary. Your average patient and average doctor aren’t aware exactly how these drugs work and aren’t familiar with the long term effects of usage.

As consumers, it is important to educate yourself, research drug side effects and if you don’t feel comfortable going on a drug for schizophrenia when you have a condition like insomnia or depression, then don’t. We can only hope that some of these drug companies invest their profits towards development of new classes of medications rather than putting a new spin on the same wheel (e.g. atypical antipsychotics, SNRI’s, etc.).

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