Chronic Pain | Disease Landscape and Forecast | G7 | 2017

Despite the extensive armamentarium of chronic pain therapies, which is increasingly subject to generic competition, the chronic pain market continues to represent a notable commercial opportunity for drug developers with differentiated products. Indeed, developers continue to pursue development of products with novel mechanisms of action as well as products with the potential to fulfill the lingering unmet need for safer and better-tolerated analgesics. Recently launched and emerging abuse-deterrent opioid analgesic reformulations, as well as novel products such as biological drugs targeting nerve growth factor, will greatly impact the overall dynamics of the chronic pain market across the major pharmaceutical markets we cover. The increasing prevalence of key population segments, including osteoarthritic pain and chronic low back pain, will be an additional driver of growth over the forecast period.

Questions Answered:

  • Over the past 15 years, long-acting and extended-release opioids have been used at high doses and over long treatment durations in chronic noncancer pain patients, particularly in the United States, resulting in a drastic increase in the number of opioid-tolerant individuals and a prescription opioid abuse epidemic. How do interviewed experts expect the use of opioid analgesics for the treatment of chronic noncancer pain to evolve over the next ten years? Do interviewed thought leaders anticipate that the implementation of mandatory Risk Evaluation and Mitigation Strategy programs or the change in indication labeling for long-acting/extended-release opioids has/will result in more-responsible prescribing practices among U.S. physicians? What is the commercial potential of emerging abuse-deterrent opioid formulations and novel opioid agents, and what are physicians’ opinions of these products?
  • Many newer-to-market products for the treatment of chronic pain have been reformulations of existing agents or drugs having mechanisms of action similar to those of current therapies. The pipeline for chronic pain therapies is similarly full of such products. What improvements do physicians desire most from emerging therapies relative to current prescription analgesics? What novel drug targets show the most commercial potential as treatments for chronic pain? How will emerging therapies most likely be positioned in the increasingly fragmented and genericized landscape?
  • Clinical development of biological therapies targeting nerve growth factor (NGF) for the treatment of chronic pain has resumed. What is interviewed experts’ opinions of these agents now that the safety risks associated with anti-NGF therapies have become clearer? What hurdles are these agents likely to face once they reach the market? What types of patients are expected to be the most likely candidates for treatment? Given the likely target chronic pain subpopulations for anti-NGF agents, what is their commercial potential?

Scope:

Markets covered: United States, France, Germany, Italy, Spain, United Kingdom, and Japan.

Primary research: 18 country-specific interviews with thought-leading physicians (including pain specialists, palliative care specialists, anesthesiologists, and neurologists).

Epidemiology: Region-specific prevalence estimates for key chronic pain populations: arthritic pain (osteoarthritic and rheumatoid), cancer pain (severe, breakthrough, neuropathic, and metastatic bone cancer pain), chronic low back pain, fibromyalgia, painful diabetic neuropathy, and postherpetic neuralgia.

Emerging therapies: Phase II: 30 drugs; Phase III: 8 drugs; preregistration/registration: 3 drugs.