Pain Management Treatment Markets

  • March 2013
  • -
  • TriMark Publications
  • -
  • 144 pages

Pain management describes a particular set of drugs, analgesics, which are specifically used as therapeutics to control pain in the clinic. As pain affects 1.5 billion people worldwide, these drugs are one of the major segments of the central nervous system (CNS) therapies market. This TriMark Publications report focuses on the role of pain management drugs in clinical use and in drug development for acute pain, chronic pain, neuropathic path and nociceptive pain. The report discusses drug development and targeted therapeutics, as well as their use in clinical trials. New approaches meant to aid in development of drugs for therapeutic use are emphasized. The study also analyzes almost all of the major, specialty and emerging companies known to be marketing, manufacturing or developing pain management treatment products in the U.S. and worldwide. Additionally, this review provides detailed tables, charts and figures with past and projected sales data for the U.S., Europe and other geographic regions.

Table Of Contents

TABLE OF CONTENTS

1. Overview 6
1.1 Statement of Report 6
1.2 About this Report 6
1.3 Scope of the Report 6
1.4 Objectives 6
1.5 Methodology 7
1.6 Executive Summary 9

2. Introduction 15
2.1 Overview of Pain 15
2.1.1 Acute Pain 15
2.1.2 Chronic Pain 16
2.1.3 Neuropathic Pain 17
2.1.4 Nociceptive Pain 18
2.2 Current Treatment Approaches 23
2.3 Key Problems 26
2.3.1 Side Effects of Therapy 26
2.3.2 Abuse Issues 27
2.4 The Need for New Treatments 37

3. Market Overview 38
3.1 Introduction 38
3.2 Market Analysis 38
3.3 Therapeutic Class 38
3.3.1 Opioids 39
3.3.2 NSAIDs 42
3.3.3 Local Anesthetics 44
3.3.4 Antidepressants 45
3.3.5 Anticonvulsants 46
3.4 Geographical Analysis 46
3.4.1 U.S. 46
3.4.2 Europe 49
3.4.3 Japan 50
3.5 Key Players 51

4. Pipeline Analysis 52
4.1 Introduction 52
4.2 Pain 54
4.3 Neuropathic Pain 55
4.4 Novel Therapeutic Approaches 56
4.4.1 CGRP Antagonists 56
4.4.2 CB2 Agonists 59
4.4.3 Sodium Channel Modulators 61
4.4.4 Calcium Channel Modulators 63
4.4.5 NMDA Antagonists 64
4.4.6 P2x Receptors 65
4.4.7 Trp Channels 67
4.5 Unsuccessful Targets 69
4.5.1 TrpV1 blockers 70
4.5.2 FAAH Inhibitors 71
4.5.3 Other Targets 73
4.6 Novel Formulations 76
4.6.1 Novel Opioids 78
4.6.2 Extended Release Formulations 79
4.6.3 Transdermal Formulations 81
4.6.4 Other Routes 82
4.6.5 Drug Combinations 82
4.7 Overview 85

5. The Changing Competitive Landscape 86
5.1 Overview 86
5.2 The Exit of Major Companies 86
5.3 Major Pharma Players 87
5.3.1 Abbott (AbbVie) 87
5.3.2 Astellas 87
5.3.3 Eli Lilly 87
5.3.4 Johnson andamp; Johnson 87
5.3.5 Novartis 88
5.3.6 Pfizer 88
5.4 Pain Specialty Companies 89
5.4.1 Cephalon (Teva) 89
5.4.2 Endo Pharmaceuticals 89
5.4.3 Grünenthal 89
5.4.4 Hospira 90
5.4.5 Purdue Pharma 90
5.4.6 Mallinckrodt 90
5.5 Emerging Biotechs 91
5.5.1 AcelRx 91
5.5.2 Acura Pharmaceuticals 91
5.5.3 Afferent Pharmaceuticals 92
5.5.4 Algiax Pharmaceuticals 92
5.5.5 Arcion Therapeutics 92
5.5.6 BioDelivery Sciences International 92
5.5.7 Cara Therapeutics 93
5.5.8 Convergence Pharmaceuticals 93
5.5.9 Cytogel Pharma 93
5.5.10 DURECT 93
5.5.11 Egalet a/s 94
5.5.12 iMed 94
5.5.13 KemPharm 94
5.5.14 NeurAxon 95
5.5.15 NeurogesX 95
5.5.16 Newron Pharmaceuticals 95
5.5.17 Nuvo Research 96
5.5.18 Pacira Pharmaceuticals 96
5.5.19 Pain Therapeutics 96
5.5.20 QRx Pharma 96
5.5.21 Relmada Therapeutics 97
5.5.22 Relevare Pharmaceuticals 97
5.5.23 Spinifex Pharma 97
5.5.24 Xenon Pharma 98
5.5.25 Xenoport 98
5.5.26 Zalicus 98
5.5.27 Zogenix 99

6. Market Outlook 100
6.1 Overview 100
6.2 Increased Demand 100
6.3 The Continued Impact of Generics 101
6.4 Key Patent Expirations 101
6.5 Key New Launches 103
6.5.1 2012 103
6.5.2 2013 104
6.5.3 2014 104
6.5.4 2015 105
6.6 Overall Assessment 105
6.7 Market Forecast 106
6.7.1 Opioids 106
6.7.2 Neuropathic Pain 107
6.7.3 Migraine 108
6.7.4 Fibromyalgia 108
6.8 Geographical Analysis 108
6.8.1 U.S. 108
6.8.2 Europe 109
6.8.3 Japan 110
6.9 Conclusions 110

7. Company Profiles 113

Glossary 132

Bibliography 134


INDEX OF TABLES

Table 2.1: Treatment Recommendations for Osteoarthritic Pain 17
Table 2.2: Competitive Landscape for Postoperative Pain Management 21
Table 2.3: A Suggested Stepwise Approach to Treating Neuropathic Pain 25
Table 2.4: EULAR Recommendations for Treating Fibromyalgia 25
Table 2.5: Remoxy Versus OxyContin OC 32
Table 3.1: Branded Opioid Formulations and their Estimated 2012 Sales 41
Table 3.2: The More Widely Used NSAIDs 43
Table 3.4: 2012 U.S. Sales of Branded Triptan Containing Products for Migraine
Pain 49
Table 4.1: NCEs in Advanced Clinical Development for the Treatment of Pain 57
Table 4.2: CGRP Antagonists in Development for the Treatment of Migraine 58
Table 4.3: Cannabinoid Receptor Agonists that are or have been in Development 59
Table 4.4: Sodium Channel Blockers in Development for Pain Indications 61
Table 4.5: Calcium Channel Blockers in Active Development for the Treatment of
Pain 63
Table 4.6: NMDA Antagonists in Development for the Treatment of Pain 65
Table 4.7: P2x Channel Blockers in Active Development for the Treatment of Pain
66
Table 4.8: Active TrpV3 and TrpV4 Modulator Programs 67
Table 4.9: TrpA1 Blockers Reported to be in Active Development 68
Table 4.10: TrpM Channel Blockers Reported to be in Active Development 69
Table 4.11: TrpV1 Blockers Identified for Development in the Treatment of Pain
70
Table 4.12: FAAH Inhibitors Being Developed for Pain Indications 72
Table 4.13: Novel Approaches to the Treatment of Pain 74
Table 4.14: Novel Opioid Formulations in Development for the Treatment of Pain
77
Table 4.15: Novel Combination Formulations in Development for the Treatment of
Pain 83
Table 6.1: Market Drivers for the Pain Management Therapeutics Market 100
Table 6.2: Market Impediments for the Pain Management Therapeutics Market 100
Table 6.3: Status of Potential New Treatments for Neuropathic Pain 107



INDEX OF FIGURES

Figure 2.1: The Diverse Forms of Neuropathic Pain 18
Figure 2.2: The WHO-Recommended Treatment Ladder for Pain 23
Figure 2.3: Approved Treatment Options for Neuropathic Pain 24
Figure 2.4: Opioid Abuse and Emergency Eepartment Visits in the U.S., 2004 to
2008 29
Figure 2.5: Trends in Drug Abuse-Related ED Visits Involving Hydrocodone and
Oxycodone, Coterminous U.S., 1994-2002 30
Figure 2.6: Opioid Plasma Concentration Versus Time, “Bolus Effect” 30
Figure 2.7: OxyContin Original (OC) and Reformulated (OP) 31
Figure 2.8: How Remoxy Hinders Potential Drug Abuse 32
Figure 2.9: The Effect of Corporate Changes on Remoxy and Pain Therapeutics 33
Figure 2.10: Tamper Proofing with the Embeda Formulation 34
Figure 2.11: How Embeda Works 34
Figure 3.1: The Pain Market 2012, Segmentation by Therapeutic Class 39
Figure 3.2: Breakdown of 2012 Opioid Sales by Drug 40
Figure 3.3: The Leading NSAIDs and their Market Share in 2012 44
Figure 3.4: U.S. Sales of Opioid Products in 2012 by Volume 47
Figure 3.5: The U.S. Neuropathic Pain Market in 2012 48
Figure 3.6: The U.S. Fibromyalgia Pain Market in 2012 49
Figure 3.7: The 2012 Pain Market, Segmentation by Company 51
Figure 4.1: Novel Approaches to the Treatment of Pain 53
Figure 4.2: Pfizer’s NCEs in Development for Pain in October 2008 54
Figure 4.3: Potential Targets for Treating Neuropathic Pain 55
Figure 6.1: Anticipated New Product Launches 2012-2015 103
Figure 6.2: Forecast Segmentation of the Pain Market in 2018 106
Figure 6.3: Forecast Breakdown of U.S. Neuropathic Pain Market in 2018 109
Figure 6.4: Geographic Distribution of the Acute and Chronic Pain Market in 2018
111
Figure 6.5: Geographic Distribution of the Migraine Market in 2018 111
Figure 6.6: Geographic Distribution of the Fibromyalgia Market in 2018 112
Figure 6.7: Geographic Distribution of the Neuropathic Pain Market in 2018 112

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