Obsessive-Compulsive Disorder - Market Insight, Epidemiology And Market Forecast - 2032

Key Highlights:

• Obsessive-compulsive disorder (OCD) has been given increased attention in DSM-5, receiving its chapter. However, the diagnostic criteria for OCD in DSM-5 remain largely the same as in DSM-IV, requiring either obsessions or compulsions. The major change in the DSM-5 criteria for OCD is the addition of two specifiers for this diagnosis: insight and tic-related disorder.
• OCD symptoms may be present for years before treatment is sought, and those affected often suffer in silence. The disease follows a chronic waxing and waning course where 15% of patients have deterioration, and 5% have episodes with inter-episode recovery.
• The diagnosis of obsessive-compulsive disorder (OCD) is established by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria, while the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is used for the assessment of its severity.
• In 2022, there were ~12,082,000 total prevalent cases of obsessive-compulsive disorder (OCD) in the 7MM.
• Most of the diagnosed cases of Obsessive Compulsive Disorder (OCD) are severe, with around 15%, 35%, and 50% of individuals having mild, moderate, and severe OCD, respectively.
• The United States accounted for the highest number of diagnosed cases of OCD in the 7MM, i.e., ~2,156,000 cases in 2022.
• In 2022, the market size of OCD was the highest in the US among the 7MM, accounting for approximately USD 600 million.
• Treatment of OCD comprises several components, starting with building a therapeutic alliance with the patient and psychoeducation. Then psychological and/or pharmacological approaches, and, for patients with treatment-resistant OCD, neuromodulation, and neurosurgery.
• The NICE guidelines propose CBT as the treatment of choice for OCD and body dysmorphic disorder due to the rigorous research invested into CBT for OCD and the effectiveness of treatment.
• The expected launch of troriluzole (Biohaven Pharmaceuticals) by 2027 is set to bring major changes in the treatment landscape of OCD, bringing in safer and more effective treatment options for OCD patients.
• Selective Serotonin Reuptake Inhibitors (SSRIs) are the most popular form of treatment for OCD, which works by increasing serotonin levels in the brain.
• Some widely used medications for the treatment of OCD are citalopram (CELEXA, CIPRAMIL), escitalopram (CIPRALEX, LEXAPRO), fluoxetine (PROZAC), fluvoxamine (FAVERIN, LUVOX), paroxetine (PAXIL, SEROXAT), sertraline (LUSTRAL, ZOLOFT). If these medications fail to work, a non-selective SRI may be prescribed. However, because it affects neurotransmitters in the brain other than just serotonin, there are more side effects, and therefore it is usually not a first-choice medication for treating OCD. The non-selective SRI most commonly used for treating OCD is clomipramine (ANAFRANIL).
• The generic alternatives of the approved marketed assets for OCD, such as sertraline hydrochloride, fluoxetine, fluvoxamine, clomipramine, etc., entered the market from 1996-2006.

The “Obsessive Compulsive Disorder (OCD) - Market Insights, Epidemiology and Market Forecast - 2032” report delivers an in-depth understanding of the OCD, historical and forecasted epidemiology as well as the OCD market trends in the United States, EU4 (Germany, Spain, Italy, and France) and the United Kingdom, and Japan.

The OCD market report provides current treatment practices, emerging drugs, market share of individual therapies, and current and forecasted 7MM OCD market size from 2019 to 2032. The report also covers current OCD treatment practices/algorithms and unmet medical needs to curate the best opportunities and assess the market's potential.

Geography Covered

• The United States
• EU4 (Germany, France, Italy, and Spain) and the United Kingdom
• Japan

Study Period: 2019-2032

Obsessive-compulsive Disorder (OCD) Disease Understanding and Treatment Algorithm

Obsessive-compulsive Disorder (OCD) Overview

Obsessive-compulsive disorder (OCD) is a mental health disorder characterized by recurring and intrusive thoughts, images, or impulses that cause significant anxiety, as well as repetitive behaviors or mental acts aimed at reducing the anxiety caused by the obsessions.

The obsessions and compulsions of OCD can significantly interfere with daily activities, relationships, and quality of life. Some common obsessions include fear of contamination, a need for symmetry or order, or intrusive thoughts. Compulsions involve repetitive behaviors such as hand-washing, counting, or repeatedly checking things.

The pathophysiology of OCD is not fully understood, but according to some research studies, brain regions impaired in OCD include the dorsolateral prefrontal cortex (DLPC), anterior cingulate cortex (ACC), basal ganglia, orbitofrontal cortex (OFC), striatum, amygdala, thalamus, and brainstem.

Obsessive-compulsive Disorder (OCD) Diagnosis

Diagnosing obsessive-compulsive disorder (OCD) involves a comprehensive assessment by a mental health professional, such as a psychiatrist, psychologist, or clinical social worker. The diagnosis of OCD is typically based on a combination of clinical evaluation, symptom assessment, and ruling out other potential causes for the symptoms. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria is used to establish the diagnosis of OCD in a patient.

The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was designed to remedy the problems of existing rating scales by providing a specific measure of the severity of symptoms of obsessive-compulsive disorder that is not influenced by the type of obsessions or compulsions present. The Y-BOCS is a 10-item, clinician-administered, widely used rating scale for OCD. The Y-BOCS is designed to rate symptom severity, not to establish a diagnosis.

Obsessive-compulsive Disorder (OCD) Treatment

There are several effective treatment options for obsessive-compulsive disorder (OCD), including cognitive-behavior therapy (CBT), medication, or a combination. CBT focuses on changing negative thought patterns, while medications help alleviate the symptoms by regulating brain chemicals.

Current medication-based treatment of OCD involves Selective Serotonin Reuptake Inhibitors (SSNRIs) to increase serotonin levels in the brain, which helps reduce symptoms of OCD. The most commonly used medications that are also FDA-approved are sertraline (ZOLOFT), fluoxetine (PROZAC), fluvoxamine (LUVOX), paroxetine (PAXIL), and clomipramine (ANAFRANIL) paroxetine mesylate (PEXEVA).

OCD often co-occurs with other mental health disorders like depression and anxiety. It becomes quite challenging to treat these co-morbidities alongside OCD, as different disorders might require different treatment approaches. Moreover, the social stigma associated with mental illness can make it difficult for individuals to seek help and openly express their experiences.

Obsessive-compulsive Disorder (OCD) Epidemiology

As the market is derived using a patient-based model, the obsessive-compulsive disorder (OCD) epidemiology chapter in the report provides historical as well as forecasted epidemiology segmented by total prevalent cases of OCD, total diagnosed cases of OCD, gender-specific cases of OCD, severity-specific cases of OCD and age-specific cases of OCD in the 7MM covering the United States, EU4 countries (Germany, France, Italy, and Spain), United Kingdom, and Japan from 2019 to 2032. The total prevalent cases of OCD in the 7MM comprised approximately 12,082,000 cases in 2022, which are projected to increase during the forecasted period.

• The total number of prevalent cases of OCD in the United States was around 3,528,000 cases in 2022.
• The United States contributed to ~29% of the prevalent population of OCD in the 7MM in 2022. While EU4 and the UK, and Japan accounted for around 53% and 18% of the total prevalent population share of the 7MM, respectively, in 2022.
• Among the EU4 and the UK, Germany accounted for the highest number of OCD prevalent cases, followed by France, whereas the United Kingdom accounted for the lowest number of prevalent cases in 2022.
• Japan accounted for about 1,099,000 diagnosed cases of OCD in 2022.

Obsessive-compulsive Disorder (OCD) Drug Chapters

The drug chapter segment of the obsessive-compulsive disorder (OCD) report encloses a detailed analysis of OCD-marketed drugs and late-stage (Phase III and Phase II) pipeline drugs. It also helps understand the OCD clinical trial details, expressive pharmacological action, agreements and collaborations, approval and patent details, advantages and disadvantages of each included drug and the latest news and press releases.

Marketed Drugs

ZOLOFT (sertraline hydrochloride): Biohaven Pharmaceuticals

Sertraline hydrochloride is the hydrochloride salt of sertraline, a synthetic derivative of naphthalenamine with anti-serotoninergic and antidepressant properties. Sertraline selectively inhibits the neuronal uptake of serotonin, raising serotonin levels in the CNS.

It is a hydrochloride resulting from the reaction of equimolar amounts of sertraline and hydrogen chloride. A selective serotonin-reuptake inhibitor (SSRI) is administered orally as an antidepressant to treat depression, OCD, panic disorder, and post-traumatic stress disorder. It has a role as a serotonin uptake inhibitor and an antidepressant. Sertraline potentiates serotonergic activity in the central nervous system by inhibiting neuronal reuptake of serotonin (5-HT).

For the treatment of OCD, sertraline hydrochloride is dosed at a starting dose of 25 mg per day (aged 6-12) and 50 mg per day (aged =13). If there is an inadequate response to starting dose, it is to be titrated in 25-50 mg daily increments once weekly in OCD. The maximum dosage is 200 mg per day.

In 1996, ZOLOFT was approved by the US FDA to treat OCD. In 2001, the generic entry of this drug took place in the United States.

Note: Detailed current therapies assessment will be provided in the final report.

Emerging Drug

Troriluzole: Biohaven Pharmaceuticals

Troriluzole is a new chemical entity and tripeptide prodrug of the active metabolite, riluzole. Troriluzole is optimized for improved bioavailability, pharmacokinetics, tolerability, and dosing compared to its active metabolite. Based on its mechanism of action, preclinical data, and clinical studies, troriluzole has the potential for therapeutic benefit in neurological and neuropsychiatric illnesses.

Troriluzole has the potential to be developed in a number of other diseases associated with excessive glutamate. Clinical trials are underway to evaluate the efficacy of troriluzole in OCD. The rationale for using troriluzole in OCD is supported by clinical data with its active metabolite, riluzole, in populations with OCD in open-label and placebo-controlled clinical trials as well as in preclinical, genetic, and neuroimaging studies implicating the glutamatergic hyperactivity in the pathogenesis of OCD.

The drug could potentially be the best-in-class treatment for OCD patients. The Phase II/III study demonstrated promising preliminary results, a consistent numerical improvement over placebo on the Yale-Brown Obsessive Compulsive Scale (YBOCS), and manageable adverse events. These results supported its continued evaluation in Phase III studies, which, if successful, will lead to the FDA approval of the drug before 2028. Key opinion Leaders (KOLs) are convinced with the tolerability and effectivity of troriluzole in clinical trials and have shown a preference toward troriluzole over currently used therapies for treating OCD.

Note: Detailed emerging therapies assessment will be provided in the final report.

Drug Class Insights

The existing treatment landscape of obsessive-compulsive disorder (OCD) is mainly dominated by selective serotonin-reuptake inhibitors (SSRIs). Although other classes of drugs like serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCA), and antipsychotics are also used at times, they are still not as frequently used as SSRIs for the treatment of OCD.

Monoclonal antibodies like troriluzole are exploring the effectiveness of glutamate release inhibition in treating OCD. Its successful approval could hence bring a new class of drug into the treatment landscape of OCD.

Obsessive-compulsive Disorder (OCD) Market Outlook

The most effective treatments for obsessive-compulsive disorder (OCD) are Cognitive Behavior Therapy (CBT) and/or medication. First-line treatments include cognitive-behavioral therapy and pharmacotherapy with selective serotonin reuptake inhibitors (SSRIs). More specifically, the most effective treatments are a type of CBT called Exposure and Response Prevention (ERP), which has the strongest evidence supporting its use in the treatment of OCD, and/or a class of medications called serotonin reuptake inhibitors, or SRIs. Exposure and Response Prevention is typically done by a licensed mental health professional (such as a psychologist, social worker, or mental health counselor) in an outpatient setting. This means patients may visit therapists at a set appointment time once or a few times a week. Medications can only be prescribed by a licensed medical professional (such as a physician or a psychiatrist), who would ideally work together with the patient's therapist to develop a treatment plan.

Selective Serotonin Reuptake Inhibitors (SSRIs) and/or CBT with exposure and response prevention (ERP) are the first-line treatments for OCD, but about 40-60% of patients fail to respond. Regardless of the optimal cognitive behavioral therapy and augmentation of pharmacologic treatment, about 10% of the patients stay treatment-resistant. Treatment-resistant OCD remains an important cause of suffering and disability associated with mental disorders. The second-line treatments include augmentation treatment with antipsychotics, electroconvulsive therapy, transcranial magnetic stimulation, and deep brain stimulation (DBS). Despite the level of treatment, the greatest unmet need of OCD patients and their families is the problem of finding adequate treatment for OCD with access to appropriate pharmacotherapy and/or cognitive behavioral therapy. The problem could also be the treatment affordability, adequate pharmacy doses, and information about the possible treatment response and relapse prevention.

Despite these huge unmet needs, OCD, once a neglected illness, is recognized as a common, highly disabling, and potentially treatable early-onset brain disorder. Clinical and translational research in OCD grows apace. Over the past 10 years, it has contributed to substantial advances in understanding phenomenology, brain-based biology, and treatment response, leading to innovations in nosological conceptualizations, therapeutic interventions, and services. This increase in awareness about the symptoms, diagnosis, causes, and treatments for OCD across the globe has led to the development of targeting novel pathways. The major pharma player currently developing a therapy for OCD include Biohaven Pharmaceuticals' BHV-4157 (troriluzole).

In a nutshell, it can be summarized that as a result of the discovery of new aspects of disease etiology and increasing awareness, more potential therapeutic targets are being identified, which may lead to a surge in potential therapies being investigated for managing OCD in the future; it is safe to predict that the treatment space will experience significant reconstitution during the forecast period of 2022-2032. However, the challenges of relapse, treatment resistance, and side effects will decide the fate of the pipeline therapies and their impact on overall revenue generation.

• The total market size of OCD in the 7MM is approximately ~USD 1,000 million in 2022 and is projected to increase during the forecast period (2023-2032).
• The market size in the 7MM will increase at a CAGR of ~5% due to an increase in the prevalent pool of the disease and the launch of a new therapy.
• Among EU4 and the UK, Germany accounts for the maximum market size in 2022, while the United Kingdom occupies the bottom of the ladder in 2022.
• In Japan, selective serotonin reuptake inhibitors (SSRIs) had a revenue of ~USD 40 million in 2022 for treating OCD.

Obsessive-compulsive Disorder (OCD) Drugs Uptake

This section focuses on the uptake rate of potential drugs expected to be launched in the market during 2019-2032. For example, for troriluzole, we expect the drug uptake to be slow-medium with a probability-adjusted peak share of ~4%; years to the peak is expected to be around 8 years from the year of launch.

Obsessive-compulsive Disorder (OCD) Pipeline Development Activities

The report provides insights into different therapeutic candidates in Phase III, Phase II, and Phase I stage. It also analyzes key players involved in developing targeted therapeutics.

Pipeline Development Activities

The report covers information on collaborations, acquisitions and mergers, licensing, and patent details for obsessive-compulsive disorder (OCD) emerging therapies.

KOL Views

To keep up with current market trends, we take KOLs and SMEs' opinions working in the domain through primary research to fill the data gaps and validate our secondary research. Industry Experts contacted for insights on the obsessive-compulsive disorder (OCD) evolving treatment landscape, patient reliance on conventional therapies, patient's therapy switching acceptability, and drug uptake along with challenges related to accessibility, including Medical/scientific writers, Psychiatrists, Professors, Psychotherapists of the University of Lubeck, Neuropsychiatrists of the Osaka City University Medical School, and Others.

The analysts connected with 50+ KOLs to gather insights; however, interviews were conducted with 15+ KOLs in the 7MM. Centers such as the Department of Health Care Policy of Harvard Medical School, the Department of Child and Adolescent Psychiatry of the Institute of Psychiatry, the Institute for Psychiatric Assessment, etc., were contacted. Their opinion helps understand and validate current and emerging therapy treatment patterns or OCD market trends. This will support the clients in potential upcoming novel treatments by identifying the overall scenario of the market and the unmet needs.

Qualitative Analysis

The publisher performs Qualitative and market Intelligence analysis using various approaches, such as SWOT analysis. In the SWOT analysis, strengths, weaknesses, opportunities, and threats in terms of disease diagnosis, patient awareness, patient burden, competitive landscape, cost-effectiveness, and geographical accessibility of therapies are provided. These pointers are based on the analyst's discretion and assessment of the patient burden, cost analysis, and existing and evolving treatment landscape.

Market Access and Reimbursement

The report further provides detailed insights on the country-wise accessibility and reimbursement scenarios, cost-effectiveness scenario of approved therapies, programs making accessibility easier and out-of-pocket costs more affordable, insights on patients insured under federal or state government prescription drug programs, etc.

Scope of the Report

• The report covers a segment of key events, an executive summary, descriptive overview of obsessive-compulsive disorder (OCD), explaining its causes, signs and symptoms, pathogenesis, and currently available therapies.
• Comprehensive insight has been provided into the epidemiology segments and forecasts, the future growth potential of diagnosis rate, disease progression, and treatment guidelines.
• Additionally, an all-inclusive account of the current and emerging therapies, along with the elaborative profiles of late-stage and prominent therapies, will impact the current treatment landscape.
• A detailed review of the obsessive-compulsive disorder (OCD) market, historical and forecasted market size, market share by therapies, detailed assumptions, and rationale behind our approach is included in the report, covering the 7MM drug outreach.
• The report provides an edge while developing business strategies, by understanding trends, through SWOT analysis and expert insights/KOL views, patient journey, and treatment preferences that help shape and drive the 7MM obsessive-compulsive disorder (OCD) market.

Obsessive-compulsive Disorder (OCD) Report Insights

• Patient Population
• Therapeutic Approaches
• Obsessive-compulsive Disorder (OCD) Pipeline Analysis
• Obsessive-compulsive Disorder (OCD) Market Size and Trends
• Existing and Future Market Opportunity

Obsessive-compulsive Disorder (OCD) Report Key Strengths

• 10 years Forecast
• The 7MM Coverage
• Obsessive-compulsive Disorder (OCD) Epidemiology Segmentation
• Key Cross Competition
• Attribute Analysis
• Drugs Uptake and Key Market Forecast Assumptions

Obsessive-compulsive Disorder (OCD) Report Assessment

• Current Treatment Practices
• Unmet Needs
• Pipeline Product Profiles
• Market Attractiveness
• Qualitative Analysis (SWOT)

Key Questions Answered

Market Insights

• What was the obsessive-compulsive disorder (OCD) total market size, the market size by therapies, and market share (%) distribution in 2019, and what would it look like by 2032? What are the contributing factors for this growth?
• How will glutamate-release inhibitors as a class affect the treatment paradigm of obsessive-compulsive disorder (OCD)?
• What kind of uptake glutamate release inhibitors are set to witness in obsessive-compulsive disorder (OCD) patients in the coming 10 years?
• What will be the impact of emerging therapies on the current treatment landscape?
• How will glutamate-release inhibitors compete with selective serotonin-reuptake inhibitors (SSRIs)?
• What are the pricing variations among different geographies for approved and off-label therapies?
• How would the market drivers, barriers, and future opportunities affect the market dynamics and subsequent analysis of the associated trends?

Epidemiology Insights

• What are the disease risk, burdens, and unmet needs of obsessive-compulsive disorder (OCD)? What will be the growth opportunities across the 7MM concerning the patient population of obsessive-compulsive disorder (OCD)?
• What is the historical and forecasted obsessive-compulsive disorder (OCD) patient pool in the United States, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan?
• What factors affect the increase in the prevalence of obsessive-compulsive disorder (OCD)?

Current Treatment Scenario, Marketed Drugs, and Emerging Therapies

• What are the current options for treating obsessive-compulsive disorder (OCD)?
• How many companies are developing therapies for treating obsessive-compulsive disorder (OCD)?
• How many emerging therapies are in the mid-stage and late stage of development for treating obsessive-compulsive disorder (OCD)?
• What are the recent novel therapies, targets, mechanisms of action, and technologies developed to overcome the limitation of existing therapies?
• What key designations have been granted for the emerging therapies for obsessive-compulsive disorder (OCD)?
• What is the cost burden of approved therapies on the patient?
• Patient acceptability in terms of preferred treatment options as per real-world scenarios?
• What are the country-specific accessibility issues of approved therapies? Focus on reimbursement policies.
• What is the 7MM historical and forecasted market of obsessive-compulsive disorder (OCD)?

Reasons to Buy

• The report will help develop business strategies by understanding the latest trends and changing treatment dynamics driving the obsessive-compulsive disorder (OCD) Market.
• Insights on patient burden/disease prevalence, evolution in diagnosis, and factors contributing to the change in the epidemiology of the disease during the forecast years.
• Understand the existing market opportunity in varying geographies and the growth potential over the coming years.
• Distribution of historical and current patient share based on real-world prescription data along with reported sales of approved products in the US, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan.
• Identifying strong upcoming players in the market will help devise strategies to help get ahead of competitors.
• Detailed analysis and ranking of class-wise potential current and emerging therapies provide visibility around leading classes.
• Highlights of Access and Reimbursement policies of approved therapies, barriers to accessibility of off-label therapies, and patient assistance programs.
• To understand Key Opinion Leaders' perspectives around the accessibility, acceptability, and compliance-related challenges of existing treatment to overcome barriers in the future.
• Detailed insights on the unmet need of the existing market so that the upcoming players can strengthen their development and launch strategy.