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The pharma industry is 

an essential part of understanding the mental health industry as a whole.

Click on one of the 3 topics below to get a sense of the important policies, medications and economics that shape the behavioral health field. 

Pharma economics & policy 101

Understanding the pharmaceutical industry can seem like a daunting, complicated task. In order to understand how it works in the context of behavioral health, it's important to know some basics about the industry as a whole. Check out the topics below to learn more. It’s not a secret that the pharmaceutical industry is a mega industry. By almost any standard, pharma is always in at least the top 5 most profitable industries-usually top 3- in the US in recent years. There are a few reasons why this is so, but in 2013, the pharma was a $350 billion a year industry. 

 

Drug Spending:

80% of the drug spending is on drugs that are still patented; aka a generic-therefore cheaper-option is not available.  However, 80% of prescriptions are filled as generics but those count for only 20% of total drug spending. Why? Because generics are inexpensive. Therefore, patented drugs make up the remaining 80% of total drug spending. Why is this? Well, the drug industry is a very effective lobbying group and they have great deal of influence in the way our laws about drug patents and reimbursement are written. The US is the only developed country in which what a drug costs basically whatever its manufacturer wants to charge. In other nations, there is typically a negotiation about what a given drug will cost for their health system. Another reason costs are so high is because about 10 companies have approximately a third of the market share, making it one of the more concentrated and profitable industries.

 

Top Pharma Companies:

Some of the top pharma corporations are Johnson & Johnson, Pfizer, Merck, Bayer, Novartis and Eli Lilly to name a few. (SOURCE) According to this FiercePharma article (http://www.fiercepharma.com/sales-and-marketing/pfizer-forest-and-lilly-dominate-top-10-ranking-of-psych-meds), Pfizer, Forest Laboraties and Eli Lilly are the  pharma companies that are responsible for the top selling psych meds. See more on psych meds below. 

On R & D costs: 

-Direct quote from (SOURCE): “Now the industry does spend a fair amount of money-a great deal of money-on research and development...and that's produced a lot of drugs, but it's important to realize that many of those drugs were based on very important insights about the way receptors work and the way diseases progress. That is often funded by the public and through NIH, the National Institutes of Health, and taking place in nonprofit institutions like universities and teaching hospitals...but only the ultimate product can be patented, and that's why the industry that has the product and is able to commercialize that discovery gets to keep all the profits...the drug industry spends only about 15% of its revenue on research and development, or $0.15 out of every dollar...and the rest of the $0.85 on the dollar tends to be spent on things like administration, marketing, promotion, cost of goods, shareholder profit, and so forth.”

Source: Edx professor

Major Psych Meds

Top Psych Meds in 2013:

Xanax (anti-anxiety): Produced by Pfizer

Zoloft (anti-depressant): Produced by Pfizer

Celexa (anti-depressant): Produced by Forest Laboratories

Prozac (anti-depressant): Produced by Eli Lilly

Effexor (anti-depressant): Produced by Pfizer

Source: https://psychcentral.com/lib/top-25-psychiatric-medication-prescriptions-for-2013/

Overview of Mental Health Medications:

Antidepressants: Although only approved by the FDA to be treated for depression, antidepressants can also be help with ADHD and anxiety.

Most types of antidepressants are selective serotonin reuptake inhibitors (SSRIs):

Fluoxetine (Prozac)

Citalopram (Celexa)

Sertraline (Zoloft) 

Paroxetine (Paxil, Pexeva) 

Escitalopram (Lexapro)

OR they are serotonin and norepinephrine reuptake inhibitors (SNRIs): 

Venlafaxine (Effexor) 

Duloxetine (Cymbalta)

Bupropion  is another  type of antidepressant that is typically used to treat seasonal affective disorder and to help people stop smoking.

Anti-Anxiety:

Benzodiazepines are typically used to treat general anxiety disorder. These include:

Stimulants:

Stimulants typically increase energy and  elevate blood pressure, heart rate, and respiration (National Institute on Drug Abuse, 2014). Stimulant medications can also be prescribed for children, adolescents, or adults diagnosed with ADHD.

    

Antipsychotics:

Antipsychotic medicines are primarily used to manage psychosis, or conditions in which there has been some loss of contact with reality, often including delusions or hallucinations. 

Antipsychotic medications can be used to treat delirium, dementia, and mental health conditions, including ADHD, eating disorders, PTSD (Post-traumatic stress disorder), OCD (Obsessive Compulsive Disorder) and sever depression. Some conventional antipsychotics are: 

​Newer antipsychotics include: 

Mood Stabilizers: Often used to treat bipolar disorder, mood stabilizers can also be used in combination to alleviate mood swings and symptoms of other mental disorders.  They can also be used to help treat severe depression, schizoaffective disorder and disorders of impulse control.  

Lithium is one of the most common mood stabilizers and often used to treat bipolar disorder.   Other meds include anticonvulsant medications, which include:

Source: https://www.nimh.nih.gov/health/topics/mental-health-medications/index.shtml#part_149855