ChangeWave Research: ADHD & Insomnia Treatments
ChangeWave Research Report:
ADHD & Insomnia Treatments
Adderall Share Falling Due to Recent ADHD Treatment Warnings;
Ambien #1 for Insomnia but Also Hurt by Reports of Side Effects
Overview
During the week of April 7-10, 2006 we surveyed Alliance healthcare industry members about ADHD and Insomnia treatments. A total of 102 members participated, including 36 clinicians directly involved with ADHD, and 69 respondents involved with Insomnia.
Bottom Line: Respondents reported Adderall and Ritalin were the two ADHD drugs most prescribed by their practice over the past 12 months. However, concerns about side effects and stronger “black box” warnings appear to be having a negative impact on Adderall – with 2-in-5 respondents saying Adderall will be most affected by recent discussions of side effects, more than any other ADHD drug in the survey.
Looking ahead 12 months, respondents report Ritalin, Concerta and Strattera are the ADHD drugs they will prescribe most. Daytrana – a newly approved ADHD patch – also looks well positioned in the ADHD market, despite its narrow label (children ages 6-12).
In terms of Insomnia drugs, Ambien is clearly the 800-pound gorilla. Respondents report Ambien was prescribed most to their Insomnia patients over the past 12 months, and will continue to be prescribed most over the next 12 months. However, Ambien appears most likely to be hurt by recent negative reports on Insomnia drug side effects.
Lunesta, from Sepracor (SEPR), looks best positioned to scoop up any lost market share.
Key Survey Findings:
(A) ADHD Treatments
· Most Prescribed ADHD Treatments. Over the past 12 months, Adderall (72%) and Ritalin (69%) were the most prescribed ADHD treatments for patients under age 18, followed by Concerta (61%).
For adult patients (over age 18), the top ADHD treatments were Adderall (42%), Ritalin (39%), Strattera (36%) and Concerta (31%).
· Next 12 Months – Top ADHD Treatments. Looking ahead 12 months, respondents report that Ritalin (36%) and Concerta (33%) will be the most prescribed ADHD treatments for patients under age 18, followed by Adderall (25%).
For adult patients, Ritalin (25%), Strattera (25%) and Adderall (22%) will be the ADHD Treatments respondents prescribe most over the next 12 months.
· Concerns Over “Black Box” Warning Labels. More than a quarter of respondents (28%) say they are less likely to prescribe ADHD drugs, because of recent findings on side effects and strengthened “black box” warning labels. Additionally, more than 2-in-5 (42%) say they’ve noticed a reduction in patient acceptance of ADHD drugs.
(B) Insomnia Treatments
· Ambien Most Prescribed Over Past 12 Months. Ambien (71%) was by far the most prescribed drug for Insomnia for patients under 65. Lunesta (49%) and Ativan (45%) were second and third, respectively.
For patients over 65, Ambien (68%) was also chosen as the most prescribed Insomnia drug over the past 12 months, followed by Lunesta (55%).
· Next 12 Months – Ambien Again on Top. Looking ahead 12 months, respondents picked Ambien (51%) as the Insomnia drug they believe will be prescribed most for their patients under 65, followed by Lunesta (42%).
For patients over 65, Ambien again tops the list of Insomnia drugs – with 51% of respondents reporting they'll prescribe/recommend it most over the next 12 months. Once more, Lunesta (35%) is second.
· Concerns Over Insomnia Drug Side Effects. Nearly 1-in-3 respondents (30%) report they are now less likely to prescribe Insomnia drugs due to recent reports about side effects. In addition, 29% say they’ve noticed a reduction in patient acceptance of Insomnia drugs.
· Ambien is Most Affected By Reports on Negative Side Effects. More than half of respondents (52%) say Ambien will be negatively affected by recent reports on side effects, significantly higher than any of the other Insomnia drugs mentioned.
Summary of Key Findings
The ChangeWave Alliance is a group of 7,500 highly qualified business, technology, and medical professionals in leading companies of select industries—credentialed professionals who spend their everyday lives working on the frontline of technological change. ChangeWave surveys its Alliance members on a range of business and investment research and intelligence topics, collects feedback from them electronically, and converts the information into proprietary quantitative and qualitative reports.
Helping You Profit From A Rapidly Changing World ™
www.ChangeWaveResearch.com
Table of Contents
Summary of Key Findings 2
The Findings 4
(A) ADHD Treatments 4
(B) Insomnia Treatments 9
ChangeWave Research Methodology 13
About ChangeWave Research 14
I. The Findings
Introduction
During the week of April 7-10, 2006 we surveyed Alliance healthcare industry members about ADHD and Insomnia treatments.
Total Respondents (n=102)
Clinicians Directly Involved with ADHD Diagnosis/Treatment (n=36)
Respondents Involved With or Knowledgeable about Insomnia Treatments (n=69)
(A) ADHD Treatments
Clinicians Directly Involved with ADHD Diagnosis/Treatment (n=36)
(1) Question Asked: What percentage of the ADHD patients at your practice/work environment are under 18 years old?
CliniciansDirectly Involved with ADHD
None / 8%
1%-10% / 14%
11%-20% / 8%
21%-30% / 6%
31%-40% / 0%
41%-50% / 0%
51%-60% / 8%
61%-70% / 3%
71%-80% / 11%
81%-90% / 19%
91%-100% / 17%
Don't Know/No Answer / 3%
Not Applicable / 3%
Consensus Estimate = 54%
The Consensus Estimate represents the percentage of ADHD patients under 18 years old for the average respondent. In other words, in the average respondent’s practice, 54% of the ADHD patients seen are under the age of 18.
(2) Question Asked: Over the past 12 months, which of the following drugs/treatments have you/your practice prescribed or recommended for ADHD patients under 18 years old? (Check All That Apply)
Adderall / 72%
Ritalin / 69%
Concerta / 61%
Strattera / 53%
Metadate / 19%
Focalin XR / 17%
Dexadrine / 17%
Attenade / 0%
Cylert / 0%
Don't Know/NA / 11%
Other / 25%
(3) Question Asked: What about ADHD patients over the age of 18? Over the past 12 months, which of the following drugs/treatments have you/your practice prescribed or recommended for ADHD patients over the age of 18? (Check All That Apply)
Clinicians Directly Involved with ADHDAdderall / 42%
Ritalin / 39%
Strattera / 36%
Concerta / 31%
Dexadrine / 8%
Focalin XR / 8%
Metadate / 6%
Cylert / 3%
Attenade / 0%
Don't Know/NA / 28%
Other / 22%
Most Prescribed ADHD Treatments. Over the past 12 months, Adderall (72%) and Ritalin (69%) were the most prescribed ADHD treatments for patients under age 18, followed by Concerta (61%).
For adult patients (over age 18), the top ADHD treatments were Adderall (42%), Ritalin (39%), Strattera (36%) and Concerta (31%).
(4) Question Asked: Looking ahead 12 months, which of the following drugs/treatments do you think you/your practice will prescribe or recommend most for ADHD patients under 18 years old? (Please Choose No More Than Two)
Clinicians Directly Involved with ADHDRitalin / 36%
Concerta / 33%
Adderall / 25%
Strattera / 22%
Focalin XR / 6%
Cylert / 3%
Attenade / 0%
Dexadrine / 0%
Metadate / 0%
Don't Know/NA / 14%
Other / 8%
(5) Question Asked: And looking ahead 12 months, which of the following drugs/treatments do you think you/your practice will prescribe or recommend most for ADHD patients over the age of 18? (Please Choose No More Than Two)
Clinicians Directly Involved with ADHDRitalin / 25%
Strattera / 25%
Adderall / 22%
Concerta / 14%
Focalin XR / 8%
Cylert / 3%
Attenade / 0%
Dexadrine / 0%
Metadate / 0%
Don't Know/NA / 28%
Other / 14%
Next 12 Months – Top ADHD Treatments. Looking ahead 12 months, respondents report that Ritalin (36%) and Concerta (33%) will be the most prescribed ADHD treatments for patients under age 18, followed by Adderall (25%).
For adult patients, Ritalin (25%), Strattera (25%) and Adderall (22%) will be the ADHD Treatments respondents prescribe most over the next 12 months.
(6A) Question Asked: Have recent discussions about side effects and “black box” warnings for ADHD drugs made you/your practice less likely to prescribe or recommend these drugs?
Clinicians Directly Involved with ADHDSignificantly Less Likely to Prescribe/Recommend ADHD drugs / 14%
Somewhat Less Likely to Prescribe/Recommend ADHD drugs / 14%
No Effect / 61%
Don't Know /NA / 12%
(6B) Question Asked: Have you noticed a reduction in patient acceptance of ADHD drugs as a result of recent discussions about side effects and “black box” warnings?
Clinicians Directly Involved with ADHDSignificant Reduction in Patient Acceptance of ADHD Drugs / 3%
Slight Reduction in Patient Acceptance of ADHD Drugs / 39%
No Effect / 50%
Don't Know / NA / 9%
Concerns Over “Black Box” Warning Labels. More than a quarter of respondents (28%) say they are less likely to prescribe ADHD drugs, because of recent findings on side effects and strengthened “black box” warning labels. Additionally, more than 2-in-5 (42%) say they’ve noticed a reduction in patient acceptance of ADHD drugs.
(6C) Question Asked: Which ADHD drugs will be most affected by these recent discussions about side effects and “black box” warnings? (Please Choose No More Than Two)
Clinicians Directly Involved with ADHDAdderall / 39%
Dexadrine / 28%
Strattera / 19%
Ritalin / 14%
Concerta / 8%
Cylert / 6%
Metadate / 3%
Attenade / 0%
Focalin XR / 0%
Don't Know/NA / 25%
Other / 6%
Most Affected ADHD Drugs. Nearly 2-in-5 respondents say Adderall will be most affected by recent discussions of side effects, more than any other ADHD drug in the survey. Dexadrine (28%) is second.
(7) Question Asked: The FDA just approved an ADHD patch for children ages 6-12 which delivers a generic version of Ritalin through the skin. The patch will carry the same warnings found on the labels of all other ADHD drugs, with an additional warning about possible skin irritation. The patch will be sold by Shire Pharmaceuticals under the brand name Daytrana, and will be available in four different strengths.
Are you familiar with Daytrana?
Clinicians Directly Involved with ADHDYes / 36%
No / NA / 64%
(8) Question Asked: During the next 12 months, what is the likelihood you/your practice will prescribe or recommend Daytrana for ADHD patients?
Clinicians Directly Involved with ADHDVery Likely / 22%
Somewhat Likely / 14%
Unlikely / 22%
Don't Know / 28%
Not Applicable / 14%
Good News for Daytrana. More than a third of respondents (36%) say they’re familiar with Daytrana, a new ADHD patch from Shire Pharmaceuticals. Despite only being FDA approved for children ages 6-12, 22% report being Very Likely to prescribe or recommend it for ADHD patients over the next 12 months, and another 14% say Somewhat Likely.
(B) Insomnia Treatments
These next questions were answered only by respondents who said they prescribe or are involved in evaluating treatments for Insomnia (n=69)
(9) Question Asked: What percentage of your patients with Insomnia are 65 or older?
None / 6%1%-10% / 6%
11%-20% / 14%
21%-30% / 14%
31%-40% / 13%
41%-50% / 3%
51%-60% / 13%
61%-70% / 6%
71%-80% / 12%
81%-90% / 7%
91%-100% / 0%
Don't Know/NA / 5%
Consensus Estimate = 41%
The Consensus Estimate represents the percentage of Insomnia patients over 65 for the average respondent. In other words, for the average respondent, 41% of their Insomnia patients are 65 or older.
(10) Question Asked: Over the past 12 months, which of the following Insomnia drugs/treatments have you prescribed or recommended to patients 65 or older? (Check All That Apply)
Ambien / 68%Lunesta / 55%
Restoril / 46%
Ativan / 42%
Sonata / 38%
Xanax / 35%
Antihistamines / 26%
Other Benzodiazepines / 14%
Halcion / 12%
Dalmane / 9%
Doral / 1%
ProSomL / 1%
Not Applicable / 6%
Other / 17%
(11) Question Asked: What about patients under age 65? Over the past 12 months, which of the following Insomnia drugs/treatments have you prescribed or recommended to patients under age 65? (Check All That Apply)
Ambien / 71%Lunesta / 49%
Ativan / 45%
Restoril / 39%
Sonata / 35%
Xanax / 26%
Antihistamines / 20%
Other Benzodiazepines / 13%
Halcion / 10%
Dalmane / 6%
ProSomL / 1%
Doral / 0%
Not Applicable / 1%
Other / 17%
Ambien Most Prescribed Over Past 12 Months. Ambien (71%) was by far the most prescribed drug for Insomnia for patients under 65. Lunesta (49%) and Ativan (45%) were second and third, respectively.
For patients over 65, Ambien (68%) was also chosen as the most prescribed Insomnia drug over the past 12 months, followed by Lunesta (55%).
(12) Question Asked: Looking ahead 12 months, which of the following Insomnia drugs/treatments do you think you will prescribe or recommend most to patients 65 or older? (Please Choose No More Than Two)
Ambien / 51%Lunesta / 35%
Restoril / 19%
Ativan / 16%
Sonata / 13%
Antihistamines / 9%
Xanax / 3%
Dalmane / 1%
Halcion / 1%
Other Benzodiazepines / 1%
Doral / 0%
ProSomL / 0%
Not Applicable / 9%
Other / 7%
(13) Question Asked: And looking ahead 12 months, which of the following Insomnia drugs/treatments do you think you will prescribe or recommend most to patients under age 65? (Please Choose No More Than Two)
Lunesta / 42%
Restoril / 17%
Ativan / 16%
Sonata / 14%
Antihistamines / 12%
Other Benzodiazepines / 4%
Xanax / 3%
Halcion / 1%
Dalmane / 0%
Doral / 0%
ProSomL / 0%
Not Applicable / 1%
Other / 10%
Next 12 Months – Ambien Again on Top. Looking ahead 12 months, respondents picked Ambien (51%) as the Insomnia drug they believe will be prescribed most for their patients under 65, followed by Lunesta (42%).
For patients over 65, Ambien again tops the list of Insomnia drugs – with 51% of respondents reporting they'll prescribe/recommend it most over the next 12 months. Once more, Lunesta (35%) is second.
(14A) Question Asked: Have recent reports about the side effects of Insomnia drugs made you less likely to prescribe or recommend these drugs?
Significantly Less Likely to Prescribe/Recommend Insomnia drugs / 7%Somewhat Less Likely to Prescribe/Recommend Insomnia drugs / 23%
No Effect / 64%
Don't Know/NA / 5%
(14B) Question Asked: Have you noticed a reduction in patient acceptance of Insomnia drugs as a result of recent reports about side effects?