The Global Pain Therapeutics Market, 3rd Edition - Market Analysis, R&D Pipelines and Competitive Landscape

SUMMARY

Overview

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.

The value of the pharmaceutical market for pain relief in 2008 reflects this seeming worldwide epidemic of pain. The Global Pain Therapeutics Market assesses key pain management therapeutics - such as opioids, triptans, anticonvulsants, Cox-II inhibitors and traditional NSAIDs and are discussed in terms of their past, present and future value and the role they are playing in the effective management of pain. This report discusses the key products within each of these areas and outlines the drivers of these markets as well as the restraints on them.

The Global Pain Therapeutics Market also identifies and discusses trends and issues that will have a significant impact on the pain management market and profiles the leading companies in the field. The report provides the reader with valuable information and analysis regarding key products on the market and in clinical development.

This 438-page report includes 96 profiles of companies engaged in the development and/or commercialization of pain therapeutics and over 150 tables and graphs illustrating sales trends, past and present, as well as pipelines and demographic and market trends in the area of pain management.

Key features and highlights of this report:

• Extensive review of key products indicated for pain conditions and their market value and impact
• Discussion of the key drivers of and restraints on the global pain therapeutics market
• Qualitative analysis of key pain markets and products driving growth (opioids, NSAIDs, triptans, neuropathic pain therapies (anticonvulsants) and Cox-II inhibitors)
• Profiles and reviews of key pipeline products in development for fibromyalgia, cancer pain, post-operative pain, migraine pain, neuropathic pain and opioid therapies
• Profiles of nearly 100 companies engaged in the development and/or commercialization of pain therapeutics worldwide
• Overviews of treatment options for post-operative pain, migraine pain, cancer pain, fibromyalgia, arthritic pain, back pain, neuropathic pain, and the demographic impact of these conditions.
• Chapter devoted to the role of drug delivery technologies in the current and future treatment of pain
• Discussion of promising areas of research in a variety of pain areas and companies engaged in cutting edge research and development

Key questions answered in this report:

• What is the current state of the global pain therapeutics market?
• How has the Cox-II debacle effected the market for and treatment of pain conditions?
• What pain therapies, old and new, are today proving their market and clinical value?
• What new classes of pain therapeutics are in clinical development and which classes and therapies are demonstrating superior efficacy?
• Which diseases and conditions have the most room for growth in terms of unmet need and market demand?

TABLE OF CONTENTS

1. METHODOLOGY AND EXECUTIVE SUMMARY

• 1.1 Report Objectives and Scope
• 1.2 Executive Summary

2. CAUSES, CLASSIFICATIONS AND GLOBAL IMPACT OF PAIN

• 2.1 Causes
  • 2.1.1 Terminal Illness
  • 2.1.2 Pain and Genetics
  • 2.1.3 The Immune System and Pain
  • 2.1.4 The Subjective Nature of Pain
  • 2.1.5 Pain Transmission
    • 2.1.5.1 Nociceptors
    • 2.1.5.2 Pain Receptors
• 2.2 Classifications of Pain
  • 2.2.1 Chronic Pain
  • 2.2.2 Acute Pain
• 2.3 The Impact of Pain
  • 2.3.1 Demographic Impact of Pain
  • 2.3.2 Financial Cost of Pain

3. TREATING PAIN: DRUG CLASSES AND GUIDELINES

• 3.1 NSAIDs
• 3.2 Opioids
  • 3.2.1 Chronic Pain and Opioids
• 3.3 Antidepressants
• 3.4 Anticonvulsants

4. POST-OPERATIVE PAIN OVERVIEW AND THERAPEUTICS OPTIONS

• 4.1 Impact of Post-operative Pain
• 4.2 Pain Intensity in Surgical Sites
• 4.3 Site-Specific Pain Relief
• 4.4 Post-operative Medications
  • 4.4.1 Naropin
  • 4.4.2 DepoDur, DepoMorphine and Propofol
  • 4.4.3 Other Opioids for Pain Management
  • 4.4.4 NSAIDs for Post-operative Pain

5. BACK PAIN OVERVIEW AND THERAPEUTIC OPTIONS

• 5.1 Sciatica
• 5.2 Facet Joint Problems
• 5.3 Osteoarthritis
• 5.4 Diseases and Back Pain
• 5.5 Low Back Pain
• 5.6 Pharmaceutical Relief for Back Pain
  • 5.6.1 Transdermal Patches
  • 5.6.2 Injections for Back Pain
  • 5.6.3 Back Pain and Opioids
  • 5.6.4 Tricyclic Antidepressants
  • 5.6.5 Muscle Relaxers
  • 5.6.6 Colchicine
  • 5.6.7 Chronic Low Back Pain and Anticonvulsants

6. NEUROPATHIC PAIN OVERVIEW AND THERAPEUTIC OPTIONS

• 6.1 Nociceptive Versus Neuropathic Pain
• 6.2 Nociceptive and Neuropathic Mixed Pain
• 6.3 Neuropathic Pain Generation
• 6.4 Treating Neuropathic Pain
  • 6.4.1 Tricyclic Antidepressants
  • 6.4.2 Duloxetine
  • 6.4.3 Transdermal Fentanyl
  • 6.4.4 Tramadol
  • 6.4.5 Ketamine and Alfentanil
  • 6.4.6 Neurontin
  • 6.4.7 Lyrica
  • 6.4.8 Carbamazepine
  • 6.4.9 Lidocaine

7. MIGRAINE OVERVIEW AND THERAPEUTIC OPTIONS

• 7.1 Impact of Migraines
• 7.2 Pharmacological Treatment of Migraine Pain
  • 7.2.1 Fiorinal and Fioricet
  • 7.2.2 Ergot Alkaloid Derivatives
  • 7.2.3 Triptans
    • 7.2.3.1 Comparing Triptans
    • 7.2.3.2 Imitrex
    • 7.2.3.3 Zomig
    • 7.2.3.4 Maxalt
    • 7.2.3.5 Relpax
  • 7.2.4 Neuroleptics
  • 7.2.5 Beta-Blockers
• 7.3 Alternative Therapies for Migraine

8. CANCER PAIN OVERVIEW AND THERAPEUTIC OPTIONS

• 8.1 Causes of Cancer Pain
• 8.2 Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) and Cancer Pain
• 8.3 Opioids and Cancer Pain
  • 8.3.1 Reluctance to Prescribe Opioids
• 8.4 Seizure Drugs for Cancer Pain

9. ARTHRITIC PAIN OVERVIEW AND THERAPEUTIC OPTIONS

• 9.1 Impact of Arthritis
• 9.2 Rheumatoid Arthritis
  • 9.2.1 Causes
  • 9.2.2 RA Demographics
  • 9.2.3 Genetic Susceptibility
  • 9.2.4 Environmental Factors
  • 9.2.5 High Cost of Rheumatoid Arthritis
• 9.3 Osteoarthritis
  • 9.3.1 Causes
  • 9.3.2 Pharmacological Treatment of Osteoarthritis
    • 9.3.2.1 Cox-2 Class
  • 9.3.3 Pharmacological Treatment of Rheumatoid Arthritis
• 9.4 Antirheumatic Drug Classes
  • 9.4.1 Nonsteroidal Anti-Inflammatory Drugs
  • 9.4.2 Corticosteroids

10. FIBROMYALGIA OVERVIEW AND THERAPEUTIC OPTIONS

• 10.1 Manifestations
• 10.2 Impact of Fibromyalgia
• 10.3 Natural Treatments for Fibromyalgia
• 10.4 Prescription Treatments for Fibromyalgia
  • 10.4.1 Treatment with Antidepressants
  • 10.4.2 Muscle Relaxants
  • 10.4.3 Sleep Modifiers
  • 10.4.4 Anxiety Medications
  • 10.4.5 Anticonvulsants
  • 10.4.6 Antibiotics

11. NON-PHARMACEUTICAL PAIN TREATMENT

• 11.1 Acupuncture
  • 11.1.1 Assessing Acupuncture's Value
• 11.2 Osteopathic Manipulation
  • 11.2.1 Osteopathic Treatment
  • 11.2.2 Conditions Treated by Osteopaths
• 11.3 Physiotherapy
• 11.4 Reflexology
• 11.5 Neurostructural Integration Technique
• 11.6 Herbal Medicine
• 11.7 Neurolytic Block Injections
  • 11.7.1 Examples of Neurolytic Blocks
• 11.8 Chemical Neurolytic Blocks
• 11.9 Cryoablation
• 11.10 Radiofrequency Lesioning
• 11.11 Neurosurgical Procedures
• 11.12 Chemical Ablation
• 11.13 Nerve Blocks
• 11.14 Neurostimulation and Pain Control
• 11.15 Electro Thermal Disc Decompression/ Intradiscal Electro Thermocoagulation
• 11.16 Selective Nerve Root Injections
• 11.17 Facet Joint Pain Block
• 11.18 Trigger Spot Injections
• 11.19 Peripheral Nerve Injections
• 11.20 Cervical and Lumbar Epidural Blocks
• 11.21 Cognitive Behavioral Treatment (CBT)

12. NSAID USE AND MARKET ANALYSIS

• 12.1 Overview
• 12.2 Over-the-Counter NSAIDs
  • 12.2.1 Ibuprofen
  • 12.2.2 Naproxen
  • 12.2.3 Acetaminophen and Aspirin
• 12.3 Traditional Prescription NSAIDs
  • 12.3.1 Diclofenac/Cataflam/Voltaren
  • 12.3.2 Arthrotec
  • 12.3.3 Mobic
    • 12.3.3.1 Mobic's Market Performance
    • 12.3.3.2 Mobic Vs Other NSAIDs
  • 12.3.4 DayPro
    • 12.3.4.1 Rheumatoid Arthritis Relief from DayPro
    • 12.3.4.2 Osteoarthritis Relief from DayPro
  • 12.3.5 Relafen
    • 12.3.5.1 Relafen Versus Naproxen and Aspirin
    • 12.3.5.2 Endoscopy Trials
• 12.4 The Future of the NSAID Market
• 12.5 Drivers and Constraints of the NSAID Market

13. OPIOID USE AND MARKET TRENDS

• 13.1 Drawbacks of Opioid Therapy
• 13.2 Treating Chronic Pain
• 13.3 Key Opioid Products
  • 13.3.1 Morphine
    • 13.3.1.1 Increased Usage of Morphine
    • 13.3.1.2 Cognitive and Psychomotor Effects
    • 13.3.1.3 Extended Release Morphine
      • 13.3.1.3.1 Kadian
        • 13.3.1.3.1.1 Kadian and Naltrexone 188
        • 13.3.1.3.1.2 Key Clinical Trial 188
  • 13.3.2 Codeine
  • 13.3.3 Oxycodone
  • 13.3.4 Vicodin
  • 13.3.5 Ultracet/Ultram
  • 13.3.6 Duragesic
  • 13.3.7 Fentora
  • 13.3.8 Ionsys
• 13.4 Legal Regulation of Opioids
• 13.5 Side Effects
• 13.6 Adjuvant Medications
• 13.7 Opioid Market Analysis
  • 13.7.1 OxyContin
    • 13.7.1.1 Abuse-Resistant OxyContin
    • 13.7.1.2 Generic Competition
  • 13.7.2 Duragesic
  • 13.7.3 Kadian
  • 13.7.4 Ultracet/Ultram
  • 13.7.5 Avinza
  • 13.7.6 Actiq
• 13.8 The Future of the Opioid Market
• 13.9 Drivers and Constraints of the Opioid Market

14. TRIPTANS THERAPY MARKET

• 14.1 Overview
• 14.2 Leading Migraine Therapies
  • 14.2.1 Imitrex/Imigran
  • 14.2.2 Zomig
  • 14.2.3 Relpax
  • 14.2.4 Maxalt
  • 14.2.5 Frova
• 14.3 Emerging Migraine Therapies
  • 14.3.1 Migranal
  • 14.3.2 Stavzor
• 14.4 Preventive vs. Abortive Therapy
• 14.5 The Future of the Triptans Market
• 14.6 Drivers and Constraints of the Triptan Therapy Market