With the predicted by World Health Organization that the depression may become the second largest category of disease which second only to heart disease in 2020. But in China, people began to slowly concern about depression when Prozac entered China in 1995. And then, a variety of antidepressants began to appear in the China market include western medicine and Chinese patent medicine. But antidepressant western medicines that consisting mainly by selective serotonin reuptake inhibitors (SSRIs) occupy a major share of the China antidepressant drug market with a slow growth rates. On the other hand, antidepressant Chinese patent medicines that developed based on traditional Chinese medicine theory occupy a very small market share with a high growth rates. In this study, it would analyze the development between the antidepressant western medicines and antidepressant Chinese patent medicines with the clinical efficacy and the business model theory based on the market competition. This study aims to evaluate the efficacy of Chinese patent medicines (Wuling capsule, Shuganjieyu capsule, Jieyu Pill, Jiuweizhenxin granules, Anle tablet and Neurostan) and western medicines (paroxetine, citalopram, sertraline, venlafaxine and fluoxetine) in treating depression through a systematic review and meta-analysis. And found that Chinese patent medicines are as effective as western medicines in treating depression, but the adverse events rate of Chinese patent medicines’ are less than that of western medicines’. With the business model theory, we aim to analyze the different business model characteristics of 6 different antidepressants include Wuling capsule, Shuganjieyu capsule, Leyou (paroxetine), Bolexin (venlafaxine), Seroxat (paroxetine) and Prozac (fluoxetine) through the field interviews. And found different categories of antidepressants have different business model characteristics. The Chinese patent medicines (Wuling capsule and Shuganjieyu capsule) are national new drugs and national protected variety of traditional Chinese medicines that with own intellectual property rights, and sale to mild to moderate depression patients across China with good efficacy and low adverse events rate. The generics of western medicines ( Leyou and Bolexin) are self-produced that the bioavailability is equivalent with original drugs, and sale to patients with various depression in the second and third tier cities for key markets. The original drugs (Seroxat and Prozac) are international brands which applicable to all kinds of depression, they mix self-produced and commissioned production and self-marketing and co-marketing together to sale in China especially in the first-tier cities. So we can say that they own unique business model is the most competitive in Chine antidepressant market.

抑郁症（depression），可以说是经济高速发展所致的一种“副产品”，并且 世界卫生组织预测到 2020 年抑郁症可能成为仅次于心脏病的第二大类疾病。在 中国，直到 1995 年百忧解进入中国市场，才开始慢慢引起人们对抑郁症的重视。 在中国市场的抗抑郁药主要以 SSRI 为代表的第二代抗抑郁药及在传统中医 理论基础上发展起来的抗抑郁中成药两大类别为主，并呈现化学药市场份额大却 增速慢而中成药市场份额小却增速快的市场竞争特点。因此，本研究基本于市场 竞争情况，从疗效及商业模式两个角度对比分析抗抑郁化学药与抗抑郁中成药之 间的竞争发展。 疗效角度分析是通过系统评价中成药组（乌灵胶囊、解郁丸、路优泰和舒肝 解郁胶囊）与化学药组（帕罗西汀、西酞普兰、舍曲林、文拉法辛和氟西汀）的 临床疗效，对比分析两类药品的疗效差异。发现临床疗效上抗抑郁中成药与抗抑 郁化学药品相当，可抗抑郁中成药的不良反应率要低于抗抑郁化学药品。 商业模式角度分析是通过实地访谈调研 6 个药品（乌灵胶囊、舒肝解郁胶囊、 乐友、博乐欣、赛乐特和百忧解）的商业模式以总结其各自特点。发现中成药组 （乌灵胶囊和舒肝解郁胶囊）的商业模式是自主研发，拥有自主知识产权，为国 家新药及国家中药保护品种，自主控制生产，在全国利用中成药疗效好且不良反 应发生率低等特点针对轻中度抑郁症患者销售；化学药组的仿制药（乐友和博乐 欣）的商业模式特点是自主生产与原研药生物利用度等效的仿制药，选择二三线 城市为重点市场，针对各种抑郁症患者自主营销；化学药组原研药（赛乐特和百 忧解）的商业模式特点是利用国际品牌优势，自主生产与委托生产结合，在全国 范围，特别是重点一线大城市，针对各种抑郁症患者自主营销与合作营销相结合 推广。 所以，在中国抗抑郁药品市场，无论是化学药还是中成药，临床疗效是相当 的，主要是靠自身特色的商业模式竞争。 关键词：抗抑郁药品；中成药；化学药；商业模式；系统评价；Meta 分析