New Insights into the Global Market for Pain Management
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According to Arrowhead Publishers’ new report entitled The Global Pain Therapeutics Market: Market Analysis, R&D Pipelines and Competitive Landscape, one in five people suffer from moderate to severe chronic pain, and one in three is unable or less able to maintain an independent lifestyle due to their pain. Between 50 and 60 percent of people with chronic pain are less able or unable to exercise, sleep normally, perform household chores, attend social activities, drive a car, or walk. In the US alone, some 50 million people suffer with pain.
The value of the pharmaceutical market for pain relief in 2007 reflects this seeming worldwide epidemic of pain. By the end of 2007, the value of this market will top $32 billion. The leading class of drugs for pain relief is opioids, closely followed by NSAIDs and anticonvulsants, which makes a marked change on 2004, when Cox-2 inhibitors dominated. NSAIDs also gained market share in relation to Cox-2 inhibitors, reflecting the changing trends in prescription and safety monitoring. While Cox-2 inhibitors accounted for over 27 percent of the pain market by value in 2004, this percentage fell to 11 in 2006.
Report Highlights
NSAIDs
The Cox-2 inhibitor class continued to dominate the NSAID market throughout 2004, but in light of the Vioxx withdrawals and safety concerns regarding the entire class, traditional NSAIDs regained market share throughout 2005. OTC pain relievers also recorded increased sales.
There is little doubt that traditional NSAIDs will see increased sales in light of the safety concerns surrounding the Cox-2 class of anti-inflammatories. However, not all traditional NSAIDs have the same side effect profiles. Those with fewer GI adverse events will see the greatest increase in sales. Mobic (Boehringer Ingelheim) recorded a strong increase in sales prior to mid-2006, when it faced generic competition. Its sales will continue to decline under pressure from generic rivals.
Other NSAIDs that gained market share as a result of the Cox-2 troubles include Relafen (GlaxoSmithKline), Voltaren (Novartis), DayPro (Pfizer) and Arthrotec (Pfizer). Many physicians are prescribing proton pump inhibitors along with these NSAIDs in order to reduce gastrointestinal side effects. However, the performance of Voltaren, DayPro and Relafen will also be negatively impacted by the introduction of generic competition.
Opioids
Duragesic and OxyContin continued to dominate the global opioid market in 2006, although both began to suffer from the effects of generic competition. Still, the two products represent around one-quarter of the branded opioid market. Generally speaking, generic competition is beginning to erode sales values and volumes of branded opioids.
The key to future success in the opioid market lies in innovative drug delivery mechanisms, as well as the development of abuse-resistant formulations. While prescriptions of opioid-based painkillers are on the rise across the board, a company’s ability to set themselves apart from the rest of the field will hinge on innovation. Opioid products that offer safer, tamper-resistant and more effective means of drug delivery will succeed in the coming years. Duragesic has proven to the industry that physicians prescribe medications that they believe will encourage patient compliance.
The rising number of cancer patients in the US and other key global markets will serve to boost the use of opioids. Figures such as the statistics that up to 75 percent of late-stage cancer patients suffer from moderate to severe pain testify to the size of the market and the unexplored opportunities. The fact that opioids are often combined with NSAIDs and other pain killers will also provide a further room for growth for the pain therapeutics market as a whole.
Triptans
The migraine therapy market is worth in excess of $3.5 billion. Triptans are the leading migraine therapies on the global market. The class is led by GlaxoSmithKline’s Imitrex, which has been on the market since the mid 1990s. Since 2001, sales of triptans have increased by roughly $800 million. However, the increased use of migraine prophylactics such as anti-seizure Topamax and anti-depressant Depakote has negatively impacted the growth rate of the segment, which will be further pressured by imminent generic competition.
Arrowhead believes that the triptans will continue to hold the largest share of the migraine market, but growth will be blunted by increased use of anticonvulsants, which are preferable to patients suffering from frequent migraines. The triptan market will be watered down by generic Imitrex, which will become available in late 2008.
Anticonvulsants
Anticonvulsants are one of the fastest growing drug classes on the market today. Their increasing use for pain management has led to an explosion in sales in recent years. Sales have more than doubled since 2000, due to the increased use of anticonvulsants for neuropathic pain, postherpetic neuralgia and migraine prophylaxis. While Pfizer’s new product Lyrica has the most expansive set of indications for various types of pain, sales of Depakote, Lamictal and Topamax continue to rise as well. This is mostly due to off-label prescriptions for neuropathic pain, and in the cases of Depakote and Topamax, for on-label prescriptions of migraine prophylaxis.
Cox-IIs
Overall, the Cox-2 class of drugs is unlikely to recover its reputation in the near future, at least not in the US market. This is illustrated by the FDA’s cautious approach to the approval of new drugs in the class, as well as by the outright rejection of Pfizer’s filing for Dynastat and Merck’s application for Arcoxia approval. Moreover, reports of fatal side effects associated with more recently approved Cox-2 inhibitors (such as Novartis’ Prexige) in other developed markets will do little to improve the public and professional perception of the class, providing market opportunities for other types of pain relief medications.
The Future of Pain Therapeutics
The pain therapeutics market provides considerable opportunities for pharmaceutical, biopharmaceutical and drug delivery companies alike, given the large unmet need for pain killers as well as the increased demand for more patient-friendly and abuseresistant drugs. Additionally, the high economic cost of pain serves to attract new entrants into the marketplace, as authorities seeks to contain related expenditure. On the other hand, however, the market is highly competitive, necessitating a targeted approach by various players.
In addition, as pain is a highly subjective sensation, it is often difficult to measure and compare, despite a variety of tools available. This characteristic makes the results of clinical trials more difficult to quantify and analyze, making the trial design a crucial process in the development program.
Medical, molecular and wider scientific advances are continuously improving the understanding of pain and pain processes, allowing for the identification of more compounds with a potential for pain management. Similarly, pharmacogenomics and pharmacogenetics progress has provided a new avenue for the development of more individual patient-tailored approaches to pain relief.
The comparison of emerging therapies is possible along a number of lines, such as delivery techniques. In the opioid market, for example, the search is on for a more convenient administration method than what is currently available. Sufentanil is being investigated for both transdermal – via a patch - and subcutaneous delivery, the latter using an implant system. They both have clear advantages in terms of convenience and cost over the usual intravenous administration, which requires professional supervision.
Arrowhead Publishers’ new report: The Global Pain Therapeutics Market: Market Analysis, R&D Pipelines and Competitive Landscape is now available. For sample pages or ordering information, please contact us at 1-866-397-1376 or 1-312-244-3703, email us at sales@arrowheadpublishers.net or visit our website: www.arrowheadpublishers.com