Neuropathic Pain – Unmet Need – Detailed, Expanded Analysis: Painful Diabetic Neuropathy (US/EU)

Painful diabetic neuropathy (PDN) is a prevalent complication of chronic diabetes, inducing enduring and often intense pain, characterized by sensations of burning, stabbing, tingling, and numbness, particularly in the feet and legs. Risk factor reduction, lifestyle modifications, and pharmacological treatments are all used to prevent and manage pain symptoms. Only a few pharmacological therapies are approved to treat PDN, and most are generically available, including pregabalin (Lyrica), duloxetine (Cymbalta), and gabapentin (Neurontin). Approved branded therapies with novel delivery profiles, such as Averitas’s Qutenza (capsaicin topical system), have struggled to gain a foothold in the market, indicating an opportunity for developers in the PDN market to prioritize agents that can address existing unmet needs while demonstrating superior efficacy, safety, and tolerability. Understanding prescriber perceptions and decision drivers in PDN can aid drug developers in identifying strategies for new product positioning and differentiation.


  • Which clinical endpoints and drug attributes are most influential in prescribing for PDN? How do neurologists rate the performance of key drugs on these attributes?
  • What are the prevailing areas of unmet need and opportunity in PDN?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European neurologists for a hypothetical new PDN drug?

Markets covered: United States, United Kingdom, France, Germany

Primary research: Survey of 60 U.S. and 31 European neurologists fielded in February 2024

Key drugs: Pregabalin, duloxetine, tramadol IR, gabapentin, amitriptyline, escitalopram, lidocaine patch


Unmet Need supports clinical development decisions by identifying key attributes and assessing areas of unmet need for a specific disease or subpopulation. Based on surveys with U.S. and European physicians, this report provides insight into key treatment drivers and goals, the performance of current therapies, and the remaining commercial opportunities. One market scenario is profiled in detail by Clarivate experts, and additional customized market scenarios can be evaluated with the corresponding TPP Simulator.


The Target Product Profile (TPP) Simulator tool allows for customizable market simulations based on conjoint analysis that depicts how physicians make decisions based on actual behavior rather than opinion. Compare up to seven TPPs across multiple disease-specific attributes and price points to gauge which variables influence prescribing behavior.

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