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PharmaPoint: Insomnia - Global Drug Forecast and Market Analysis to 2023

Summary

Insomnia is the most common sleep disorder and is believed to affect approximately 35% of the global population. The condition can be defined as patient-reported difficultly with sleep initiation or sleep maintenance which can include frequent awakenings, difficulty returning to sleep after awakenings, or awakening too early with inability to return to sleep. Cases of insomnia can be classified on the basis of etiology into primary and secondary (or comorbid) subtypes. The insomnia market is widely genericized creating a competitive environment for new products. As such, the treatment algorithm centers on the generically available nonbenzodiazepines and low-dose sedating antidepressants, despite the launch of numerous novel agents. The value of the insomnia market is set to further decline following the loss of exclusivity for Sunovion/Dainippon Sumitomo’s Lunesta, the top selling insomnia drug, in April 2014. However, GlobalData expects the launch of two pipeline products from a novel class of drugs to provide growth in the insomnia market as they may address some of the unmet need.

Highlights

Key Questions Answered

- The insomnia market is dominated by the generic nonbenzodiazepines and low-does sedating antidepressants. Novel products have not had a significant impact on this market as they lack notable clinical advantages over the current first-line drugs. What are the unmet needs in light of this? Will there be opportunities in this market for drug developers throughout the forecast period?
- The current late stage insomnia pipeline is sparse with only one drug having advanced to Phase III. However, GlobalData believes two orexin receptor antagonists will enter the market during the forecast period. What impact will these drugs have on the market? How will they affect the treatment algorithm for insomnia? Will these drugs fulfil any of the unmet needs for insomnia?
- Population aging is occurring in almost all countries worldwide, particularly in the 7MM. This is expected to have a significant impact on the prevalence of insomnia. How will epidemiological changes impact the growth of the future insomnia market?

Key Findings

- The main driver of growth in the insomnia market will be the introduction of the orexin receptor antagonists over the forecast period. The launch of this novel drug class may address some of the unmet need in the insomnia market due to the safety profile of these drugs and the availability of long-term clinical trial data.
- The generic erosion of Lunesta within the insomnia market will lead to a decline in market size prior to the entry of pipeline products. The availability of generic eszopiclone could greatly affect the treatment algorithm and will put downward pricing pressure on the controlled-release zolpidem generics.
- The biggest barrier for growth in the insomnia market will be fierce competition from generic products. The commercial advantages to prescribing generic drugs will make it difficult for novel products to gain traction.
- Considerable opportunity remains for products that meet the unmet needs in the insomnia market. Drugs with improved safety, which is sustained over the long-term, would hold a competitive advantage. Similarly, drugs that improve sleep quality would be viewed favorably by physicians.

Scope

- Overview of insomnia, including epidemiology, etiology, pathophysiology, symptoms, diagnosis, and treatment guidelines.
- Annualized insomnia market revenue, annual cost of therapy and treatment usage pattern data from 2013 and forecast for ten years to 2023.
- Key topics covered include market characterization, unmet needs, R&D and clinical trials assessment, late stage clinical trial analysis and implications for the insomnia therapeutics market.
- Pipeline analysis: focus on the three late-stage pipeline insomnia drugs discussing emerging trends as well as overview of earlier phase drugs.
- Analysis of the current and future market competition in the global insomnia therapeutics market. Insightful review of the key industry drivers, restraints and challenges. Each trend is independently researched to provide qualitative analysis of its implications.

Reasons to buy

- Develop and design your in-licensing and out-licensing strategies through a review of pipeline products and technologies, and by identifying the companies with the most robust pipeline.
- Additionally a list of acquisition targets included in the pipeline product company list.
- Develop business strategies by understanding the trends shaping and driving the global insomnia therapeutics market.
- Drive revenues by understanding the key trends, innovative products and technologies, market segments, and companies likely to impact the global insomnia therapeutics market in future.
- Formulate effective sales and marketing strategies by understanding the competitive landscape and by analysing the performance of various competitors.
- Identify emerging players with potentially strong product portfolios and create effective counter-strategies to gain a competitive advantage.
- Track drug sales in the global insomnia therapeutics market from 2013-2023.
- Organize your sales and marketing efforts by identifying the market categories and segments that present maximum opportunities for consolidations, investments and strategic partnerships.

Table Of Contents

PharmaPoint: Insomnia - Global Drug Forecast and Market Analysis to 2023
1 Table of Contents
1 Table of Contents 10
1.1 List of Tables 16
1.2 List of Figures 22
2 Introduction 25
2.1 Catalyst 25
2.2 Related Reports 25
3 Disease Overview 26
3.1 Etiology and Pathophysiology 26
3.1.1 Etiology 26
3.1.2 Pathophysiology 32
3.2 Classification 33
3.3 Symptoms 36
3.4 Prognosis 37
4 Epidemiology 38
4.1 Disease Background 38
4.2 Risk Factors and Comorbidities 38
4.3 Global Trends 39
4.4 Forecast Methodology 41
4.4.1 Sources Used 47
4.4.2 Sources Not Used 48
4.4.3 Forecast Assumptions and Methods 49
4.5 Epidemiological Forecast for Acute Insomnia (2013-2023) 58
4.5.1 Total Prevalent Cases of Acute Insomnia 58
4.5.2 Age-Specific Total Prevalent Cases of Acute Insomnia 60
4.5.3 Sex-Specific Total Prevalent Cases of Acute Insomnia 61
4.5.4 Age-Standardized Total Prevalence of Acute Insomnia 63
4.6 Epidemiological Forecast for Chronic Insomnia (Not Fulfilling DSM-IV Criteria) (2013-2023) 64
4.6.1 Total Prevalent Cases of Chronic Insomnia (Not Fulfilling DSM-IV Criteria) 64
4.6.2 Age-Specific Total Prevalent Cases of Chronic Insomnia (Not Fulfilling DSM-IV Criteria) 65
4.6.3 Sex-Specific Total Prevalent Cases of Chronic Insomnia (Not Fulfilling DSM-IV Criteria) 67
4.6.4 Age-Standardized Total Prevalent Cases of Chronic Insomnia (Not Fulfilling DSM-IV Criteria) 69
4.7 Epidemiological Forecast for Chronic Primary Insomnia (2013-2023) 70
4.7.1 Total Prevalent Cases of Chronic Primary Insomnia 70
4.7.2 Age-Specific Total Prevalent Cases of Chronic Primary Insomnia 71
4.7.3 Sex-Specific Total Prevalent Cases of Chronic Primary Insomnia 73
4.7.4 Age-Standardized Total Prevalence of Chronic Primary Insomnia 75
4.8 Epidemiological Forecast for Chronic Secondary Insomnia (2013-2023) 76
4.8.1 Total Prevalent Cases of Chronic Secondary Insomnia 76
4.8.2 Age-Specific Total Prevalent Cases of Chronic Secondary Insomnia 77
4.8.3 Sex-Specific Total Prevalent Cases of Chronic Secondary Insomnia 79
4.8.4 Age-Standardized Total Prevalence of Chronic Secondary Insomnia 81
4.9 Discussion 82
4.9.1 Epidemiological Forecast Insight 82
4.9.2 Limitations of the Analysis 83
4.9.3 Strengths of the Analysis 84
5 Disease Management 85
5.1 Diagnosis and Treatment Overview 85
5.1.1 Clinical Evaluation 85
5.1.2 Referral 89
5.1.3 Treatment Guidelines and Leading Prescribed Drugs 89
5.1.4 Clinical Practice 91
5.2 US 95
5.3 France 99
5.4 Germany 102
5.5 Italy 104
5.6 Spain 108
5.7 UK 111
5.8 Japan 113
6 Competitive Assessment 117
6.1 Overview 117
6.2 Product Profiles — Major Brands 120
6.2.1 Nonbenzodiazepines 120
6.2.2 Benzodiazepines 158
6.2.3 Melatonin Receptor Agonists 163
6.2.4 Low-Dose Sedating Antidepressants 182
6.2.5 Orexin Receptor Antagonists 195
6.3 Other Therapeutic Classes 206
7 Unmet Need and Opportunity 207
7.1 Overview 207
7.2 Novel Drugs with Improved Safety Profiles 208
7.2.1 Unmet Need 208
7.2.2 Gap Analysis 210
7.2.3 Opportunity 211
7.3 Drugs That Can Be Used for Long-Term Treatment 211
7.3.1 Unmet Need 211
7.3.2 Gap Analysis 212
7.3.3 Opportunity 213
7.4 Availability of Cognitive Behavioral Therapy 213
7.4.1 Unmet Need 213
7.4.2 Gap Analysis 215
7.4.3 Opportunity 215
7.5 Drugs That Improve the Quality of Sleep 216
7.5.1 Unmet Need 216
7.5.2 Gap Analysis 217
7.5.3 Opportunity 218
7.6 Education for Primary Care Physicians 218
7.6.1 Unmet Need 218
7.6.2 Gap Analysis 219
7.6.3 Opportunity 220
8 Pipeline Assessment 221
8.1 Overview 221
8.2 Clinical Trial Mapping 221
8.2.1 Clinical Trials by Sponsor Type 221
8.3 Promising Drugs in Clinical Development 222
8.3.1 E-2006 223
8.3.2 Piromelatine 228
8.4 Promising Drugs in Early-Stage Development 233
8.5 Other Drugs in Development 235
9 Current and Future Players 236
9.1 Overview 236
9.2 Trends in Corporate Strategy 240
9.3 Company Profiles 242
9.3.1 Sanofi 242
9.3.2 Sunovion/Dainippon Sumitomo 245
9.3.3 Pfizer 247
9.3.4 Takeda 251
9.3.5 Merck and Co. 254
9.3.6 Meda 258
9.3.7 Eisai 261
9.3.8 Purdue 263
9.3.9 Neurim 266
9.3.10 Pernix Therapeutics 270
10 Market Outlook 273
10.1 Global Markets 273
10.1.1 Forecast 273
10.1.2 Drivers and Barriers — Global Issues 277
10.2 United States 279
10.2.1 Forecast 279
10.2.2 Key Events 282
10.2.3 Drivers and Barriers 282
10.3 France 284
10.3.1 Forecast 284
10.3.2 Key Events 287
10.3.3 Drivers and Barriers 287
10.4 Germany 289
10.4.1 Forecast 289
10.4.2 Key Events 292
10.4.3 Drivers and Barriers 292
10.5 Italy 294
10.5.1 Forecast 294
10.5.2 Key Events 297
10.5.3 Drivers and Barriers 297
10.6 Spain 298
10.6.1 Forecast 298
10.6.2 Key Events 302
10.6.3 Drivers and Barriers 302
10.7 United Kingdom 304
10.7.1 Forecast 304
10.7.2 Key Events 307
10.7.3 Drivers and Barriers 307
10.8 Japan 309
10.8.1 Forecast 309
10.8.2 Key Events 312
10.8.3 Drivers and Barriers 312
11 Appendix 314
11.1 Bibliography 314
11.2 Abbreviations 348
11.3 Methodology 352
11.4 Forecasting Methodology 352
11.4.1 Diagnosed Insomnia Patients 352
11.4.2 Percent Drug-Treated Patients 353
11.4.3 Drugs Included in Each Therapeutic Class 353
11.4.4 Launch and Patent Expiry Dates 354
11.4.5 General Pricing Assumptions 355
11.4.6 Individual Drug Assumptions 356
11.4.7 Generic Erosion 369
11.4.8 Pricing of Pipeline Agents 370
11.5 Primary Research — KOLs Interviewed for this Report 371
11.6 Primary Research — Prescriber Survey 373
11.7 About the Authors 374
11.7.1 Analyst 374
11.7.2 Therapy Area Director 374
11.7.3 Epidemiologist 375
11.7.4 Global Head of Healthcare 375
11.8 About GlobalData 376
11.9 Disclaimer 376

1.1 List of Tables
Table 1: ICSD-2 Classification of Sleep Disorders and Subtypes of Insomnia 27
Table 2: Comorbid Psychiatric Disorders, Medical Disorders, Medications, and Substances that Can Cause Insomnia 30
Table 3: The Three Main Classifications of Insomnia Disorders 34
Table 4: Symptoms of Insomnia 36
Table 5: Risk Factors and Comorbidities for Insomnia 39
Table 6: DSM-IV Diagnostic Criteria for Primary Insomnia 42
Table 7: Sources of Epidemiological Data Used for the Forecast for Total Prevalent Cases of Acute Insomnia in the 7MM 43
Table 8: Sources of Epidemiological Data Used for the Forecast for Total Prevalent Cases of Chronic Insomnia (Not Fulfilling DSM-IV Criteria) in the 7MM 44
Table 9: Sources of Epidemiological Data Used for the Forecast for Total Prevalent Cases of Chronic Primary Insomnia in the 7MM 45
Table 10: Sources of Epidemiological Data Used for the Forecast for Total Prevalent Cases of Chronic Secondary Insomnia in the 7MM 46
Table 11: 7MM, Total Prevalent Cases of Acute Insomnia, Both Sexes, Ages ?15 Years, N, Select Years 2013-2023 59
Table 12: 7MM, Age-Specific Total Prevalent Cases of Acute Insomnia, Both Sexes, N (Row %), 2013 60
Table 13: 7MM, Sex-Specific Total Prevalent Cases of Acute Insomnia, Ages ?15 Years, N (Row %), 2013 62
Table 14: 7MM, Total Prevalent Cases of Chronic Insomnia (Not Fulfilling DSM-IV Criteria), Both Sexes, Ages ?15 Years, N, Select Years 2013-2023 64
Table 15: 7MM, Age-Specific Total Prevalent Cases of Chronic Insomnia (Not Fulfilling DSM-IV Criteria), Both Sexes, N (Row %), 2013 66
Table 16: 7MM, Sex-Specific Total Prevalent Cases of Chronic Insomnia (Not Fulfilling DSM-IV Criteria), Ages ?15 Years, N (Row %), 2013 68
Table 17: 7MM, Total Prevalent Cases of Chronic Primary Insomnia, Both Sexes, Ages ?15 Years, N, Select Years 2013-2023 70
Table 18: 7MM, Age-Specific Total Prevalent Cases of Chronic Primary Insomnia, Both Sexes, N (Row %), 2013 72
Table 19: 7MM, Sex-Specific Total Prevalent Cases of Chronic Primary Insomnia, Ages ?15 Years, N (Row %), 2013 74
Table 20: 7MM, Total Prevalent Cases of Chronic Secondary Insomnia, Both Sexes, Ages ?15 Years, N, 2013-2023 76
Table 21: 7MM, Age-Specific Total Prevalent Cases of Chronic Secondary Insomnia, Both Sexes, N (Row %), 2013 78
Table 22: 7MM, Sex-Specific Total Prevalent Cases of Chronic Secondary Insomnia, Ages ?15 Years, N (Row %), 2013 80
Table 23: Examples of Patient Questionnaires Used in the Diagnosis of Insomnia 87
Table 24: Treatment Guidelines for Insomnia 90
Table 25: Most Prescribed Drugs for Insomnia by Class in the Global Markets, 2013 91
Table 26: Country Profile — US 98
Table 27: Country Profile — France 101
Table 28: Country Profile — Germany 104
Table 29: Country Profile — Italy 107
Table 30: Country Profile — Spain 110
Table 31: Country Profile — UK 113
Table 32: Country Profile — Japan 116
Table 33: Leading Treatments for Insomnia, 2015 119
Table 34: Product Profile — Ambien/Ambien CR 122
Table 35: Ambien/Ambien CR SWOT Analysis, 2015 126
Table 36: Global Sales Forecast ($m) for Ambien, 2013-2023 127
Table 37: Global Sales Forecasts ($m) for Ambien CR, 2013-2023 127
Table 38: Product Profile — Intermezzo 130
Table 39: Pivotal Trials of Intermezzo in Insomnia 131
Table 40: Intermezzo SWOT Analysis, 2015 133
Table 41: Global Sales Forecast ($m) for Intermezzo, 2013-2023 134
Table 42: Product Profile — Zolpimist 136
Table 43: Zolpimist SWOT Analysis, 2015 138
Table 44: Global Sales Forecast ($m) for Zolpimist, 2013-2023 139
Table 45: Product Profile — Edluar 141
Table 46: Edluar SWOT Analysis, 2015 143
Table 47: Global Sales Forecast ($m) for Edluar, 2013-2023 144
Table 48: Product Profile — Lunesta 146
Table 49: Adverse Events at ?2% Incidence in Lunesta Clinical Trials 149
Table 50: Lunesta SWOT Analysis, 2015 150
Table 51: Global Sales Forecast ($m) for Lunesta, 2013-2023 151
Table 52: Product Profile — Sonata 153
Table 53: Adverse Events at ?2% Incidence in Sonata Trials 156
Table 54: Sonata SWOT Analysis, 2015 157
Table 55: Global Sales Forecast ($m) for Sonata, 2013-2023 158
Table 56: Benzodiazepine SWOT Analysis, 2015 162
Table 57: Global Sales Forecasts ($m) for the Benzodiazepines, 2013-2023 163
Table 58: Product Profile — Hetlioz 165
Table 59: Results of a Phase III clinical trial of Hetlioz in Transient Insomnia 166
Table 60: Results of a Phase III clinical trial of Hetlioz in Chronic Insomnia 167
Table 61: Adverse Events Observed in Clinical Trials of Hetlioz 168
Table 62: Hetlioz SWOT Analysis, 2015 168
Table 63: Product Profile — Rozerem 171
Table 64: Incidence (%) of Adverse Events in Rozerem's Clinical Trials 173
Table 65: Rozerem SWOT Analysis, 2015 174
Table 66: Global Sales Forecast ($m) for Rozerem, 2013-2023 175
Table 67: Product Profile — Circadin 177
Table 68: Frequency of Adverse Reactions Observed in Clinical Trials of Circadin 180
Table 69: Circadin SWOT Analysis, 2015 181
Table 70: Global Sales Forecast ($m) for Circadin, 2013-2023 182
Table 71: Product Profile — Silenor 184
Table 72: Objective Sleep Efficacy Measures of Silenor in Chronic Primary Insomnia 186
Table 73: Objective Sleep Efficacy Measures of Silenor in Elderly Chronic Primary Insomnia Patients 187
Table 74: Subjective Sleep Efficacy Measures of Silenor in Elderly Chronic Primary Insomnia Patients 188
Table 75: Incidence (%) of Adverse Events in Silenor Trials 189
Table 76: Silenor SWOT Analysis, 2015 189
Table 77: Global Sales Forecasts ($m) for Silenor, 2013-2023 190
Table 78: Low-Dose Sedating Antidepressants SWOT Analysis, 2015 194
Table 79: Global Sales Forecast ($m) for Low-Dose Sedating Antidepressants, 2013-2023 195
Table 80: Product Profile — Belsomra 198
Table 81: Pooled Sleep Efficacy Measures from Two Phase III Trials of Belsomra in Primary Insomnia 200
Table 82: Belsomra Pooled Adverse Events at ?2% Incidence in the First 3 Months of Phase III Clinical Trials 202
Table 83: Belsomra SWOT Analysis, 2015 204
Table 84: Global Sales Forecast ($) for Belsomra, 2013-2023 205
Table 85: Summary of Minor Therapeutic Classes, 2015 206
Table 86: Unmet Needs and Opportunities in Insomnia 208
Table 87: Product Profile — E-2006 224
Table 88: Sleep Efficacy Measures from a Phase I Trial of E-2006 in Primary Insomnia Patients 225
Table 89: E-2006 SWOT Analysis, 2015 227
Table 90: Global Sales Forecast ($) for E-2006, 2013-2023 228
Table 91: Product Profile — Piromelatine 230
Table 92: Piromelatine SWOT Analysis, 2015 233
Table 93: Drugs in Development, 2015 235
Table 94: Key Companies in the Insomnia Market in the 7MM, 2013 238
Table 95: Sanofi's Insomnia Portfolio Assessment, 2015 244
Table 96: Sunovion/Dainippon Sumitomo's Insomnia Portfolio Assessment, 2015 246
Table 97: Pfizer's Insomnia Portfolio Assessment, 2015 250
Table 98: Takeda's Insomnia Portfolio Assessment, 2015 253
Table 99: Merck's Insomnia Portfolio Assessment, 2015 257
Table 100: Meda's Insomnia Portfolio Assessment, 2015 260
Table 101: Eisai's Insomnia Portfolio Assessment, 2015 262
Table 102: Purdue's Insomnia Portfolio Assessment, 2015 265
Table 103: Neurim's Insomnia Portfolio Assessment, 2015 269
Table 104: Pernix Therapeutics' Insomnia Portfolio Assessment, 2015 271
Table 105: Global Sales Forecast ($m) for Insomnia, 2013-2023 275
Table 106: Insomnia Market — Drivers and Barriers, 2013-2023 277
Table 107: Sales Forecast ($m) for Insomnia in the United States, 2013-2023 280
Table 108: Key Events Impacting Sales for Insomnia in the US, 2013-2023 282
Table 109: Insomnia Market in the US — Drivers and Barriers, 2013-2023 282
Table 110: Sales Forecasts ($m) for Insomnia in France, 2013-2023 285
Table 111: Key Events Impacting Sales for Insomnia in France, 2013-2023 287
Table 112: Insomnia Market in France — Drivers and Barriers, 2013-2023 287
Table 113: Sales Forecast ($m) for Insomnia in Germany, 2013-2023 290
Table 114: Key Events Impacting Sales for Insomnia in Germany, 2013-2023 292
Table 115: Insomnia Market in Germany — Drivers and Barriers, 2013-2023 292
Table 116: Sales Forecast ($m) for Insomnia in Italy, 2013-2023 295
Table 117: Key Events Impacting Sales for Insomnia in Italy, 2013-2023 297
Table 118: Insomnia Market in Italy — Drivers and Barriers, 2013-2023 297
Table 119: Sales Forecast ($m) for Insomnia in Spain, 2013-2023 300
Table 120: Key Events Impacting Sales for Insomnia in Spain, 2013-2023 302
Table 121: Insomnia Market in Spain — Drivers and Barriers, 2013-2023 302
Table 122: Sales Forecast ($m) for Insomnia in the UK, 2013-2023 305
Table 123: Key Events Impacting Sales for Insomnia in the UK, 2013-2023 307
Table 124: Insomnia Market in the UK — Drivers and Barriers, 2013-2023 307
Table 125: Sales Forecast ($m) for Insomnia in Japan, 2013-2023 310
Table 126: Key Events Impacting Sales for Insomnia in Japan, 2013-2023 312
Table 127: Insomnia Market in Japan — Drivers and Barriers, 2013-2023 312
Table 128: Key Launch Dates 354
Table 129: Key Patent Expiries 354
Table 130: High-Prescribing Physicians (Non-KOLs) Surveyed, By Country 373

1.2 List of Figures
Figure 1: The “3P” Model of Insomnia 28
Figure 2: Global Average of the Total Prevalence of Insomnia Symptoms and Diagnoses 40
Figure 3: Patient Flow for the Epidemiological Forecast of Insomnia in the 7MM 41
Figure 4: 7MM, Total Prevalent Cases of Acute Insomnia, Both Sexes, Ages ?15 Years, N, 2013-2023 59
Figure 5: 7MM, Age-Specific Total Prevalent Cases of Acute Insomnia, Both Sexes, N, 2013 61
Figure 6: 7MM, Sex-Specific Total Prevalent Cases of Acute Insomnia, Ages ?15 Years, N, 2013 62
Figure 7: 7MM, Age-Standardized Total Prevalence of Acute Insomnia (%), Ages ?15 Years, by Sex, 2013 63
Figure 8: 7MM, Total Prevalent Cases of Chronic Insomnia (Not Fulfilling DSM-IV Criteria), Both Sexes, Ages ?15 Years, N, 2013-2023 65
Figure 9: 7MM, Age-Specific Total Prevalent Cases of Chronic Insomnia (Not Fulfilling DSM-IV Criteria), Both Sexes, Ages ?15 Years, N, 2013 67
Figure 10: 7MM, Sex-Specific Total Prevalent Cases of Chronic Insomnia (Not Fulfilling DSM-IV Criteria), Ages ?15 Years, N, 2013 68
Figure 11: 7MM, Age-Standardized Total Prevalence of Chronic Insomnia (Not Fulfilling DSM-IV Criteria) (%), Ages ?15 Years, by Sex, 2013 69
Figure 12: 7MM, Total Prevalent Cases of Chronic Primary Insomnia, Both Sexes, Ages ?15 Years, N, 2013-2023 71
Figure 13: 7MM, Age-Specific Total Prevalent Cases of Chronic Primary Insomnia, Both Sexes, N, 2013 73
Figure 14: 7MM, Sex-Specific Total Prevalent Cases of Chronic Primary Insomnia, Ages ?15 Years, N, 2013 74
Figure 15: 7MM, Age-Standardized Total Prevalence of Chronic Primary Insomnia (%), Ages ?15 Years, by Sex, 2013 75
Figure 16: 7MM, Total Prevalent Cases of Chronic Secondary Insomnia, Both Sexes, Ages ?15 Years, N, 2013-2023 77
Figure 17: 7MM, Age-Specific Total Prevalent Cases of Chronic Secondary Insomnia, Both Sexes, N, 2013 79
Figure 18: 7MM, Sex-Specific Total Prevalent Cases of Chronic Secondary Insomnia, Ages ?15 Years, N, 2013 80
Figure 19: 7MM, Age-Standardized Total Prevalence of Chronic Secondary Insomnia (%), Ages ?15 Years, by Sex, 2013 81
Figure 20: Insomnia Diagnosis Algorithm 86
Figure 21: Chronic Insomnia Treatment Algorithm 94
Figure 22: Belsomra's Development in Insomnia 199
Figure 23: Insomnia Therapeutics — Sponsor Type, 2015 222
Figure 24: Insomnia — Phase II-III Pipeline, 2015 223
Figure 25: Clinical and Commercial Positioning of E-2006 226
Figure 26: Clinical and Commercial Positioning of Piromelatine 232
Figure 27: Global Sales of Products for Insomnia by Company, 2013-2023 239
Figure 28: Company Portfolio Gap Analysis in Insomnia, 2013-2023 240
Figure 29: Sanofi SWOT Analysis in Insomnia, 2013-2023 244
Figure 30: Sunovion/Dainippon Sumitomo SWOT Analysis in Insomnia, 2013-2023 247
Figure 31: Pfizer SWOT Analysis in Insomnia, 2013-2023 251
Figure 32: Takeda SWOT Analysis in Insomnia, 2013-2023 253
Figure 33: Merck SWOT Analysis in Insomnia, 2013-2023 258
Figure 34: Meda SWOT Analysis in Insomnia, 2013-2023 261
Figure 35: Eisai SWOT Analysis in Insomnia, 2013-2023 263
Figure 36: Purdue SWOT Analysis in Insomnia, 2013-2023 266
Figure 37: Neurim SWOT Analysis in Insomnia, 2013-2023 269
Figure 38: Pernix Therapeutics SWOT Analysis in Insomnia, 2013-2023 272
Figure 39: Global Sales for Insomnia by Region, 2013-2023 276
Figure 40: Sales for Insomnia in the United States by Drug Class, 2013-2023 281
Figure 41: Sales for Insomnia in France by Drug Class, 2013-2023 286
Figure 42: Sales for Insomnia in Germany by Drug Class, 2013-2023 291
Figure 43: Sales for Insomnia in Italy by Drug Class, 2013-2023 296
Figure 44: Sales for Insomnia in Spain by Drug Class, 2013-2023 301
Figure 45: Sales for Insomnia in the UK by Drug Class, 2013-2023 306
Figure 46: Sales for Insomnia in Japan by Drug Class, 2013-2023 311

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