A Depressing Market
The market for treating depression represents one of the most promising
applications of current and future neurotechnology devices. As we
discuss in our two page 1 articles this month, both vagus nerve
stimulation (VNS) and repetitive transcranial magnetic stimulation
(rTMS) are being targeted at the condition.
It doesnt take a lot of market research to see the potential
market opportunity here. Government and nonprofit sources peg the
size of the population at between 15 and 20 million people in the
U.S. alone. This corresponds to a market value of $12 to $15 billion.
Cyberonics estimates that
if its product achieves the same rate of penetration in depression
that it did in the epilepsy market, the company would achieve $1
billion in annual sales by its fifth year in the market.
Perhaps the most striking aspect of the market potential for depression
is that about 30 percent of the existing population is resistant
to current treatments. This not only opens the door to a willing
customer base, it also encourages regulatory agencies and insurance
companies to be more receptive to new treatments that address the
patients who fall through the cracks of drug treatment.
While the upfront cost of devices such as Neuronetics
rTMS stimulator and Cyberonics NCP is considerably greater
than that for pharmaceutical treatment, it should be clear to any
bean counter that that cost differential could be easily eaten up
by several years supply of antidepressants that just dont
work. Factor in the cost of extra medical treatment, testing, psychiatric
evaluation, and lost productivity during the time that the unresponsive
30 percent discover that they actually are unresponsive, and the
equipment costs here become more bearable.
The competitive case against electroconvulsive therapy will likely
be an easier one for neurotechnology vendors to make. To begin with,
ECT is already a hardware approach to treating depression, and not
one that has always conjured up a positive reaction among the general
public. The capability for greater parametric control that neurotech
devices offer should also appeal to clinicians and patients.
Of course, it is still too early to predict enormous growth rates
for neurotechnology devices in the depression market. There is much
more research, testing, and approval cycles that must be completed
before either device penetrates the market in a big way. Research
on uncovering the mechanisms by which neuromodulationbe it
via direct stimulation of the cortex or indirect via the vagus nervesexerts
its effects on mood and behavior will be of paramount importance.
But these are issues that the pharmaceutical industry must also
address. We suspect that as more is learned about how and why we
become depressed, the opportunity for specific device approaches
will make neurotech vendors more cheerful.
Editor and Publisher