Abstract
A Complex Market of Diverse Needs
Neuropathic pain (NP) can have chronic, debilitating impact on the lives of
patients with a variety of conditions, including low back pain, diabetes,
herpes, trigeminal neuralgia, HIV/AIDS, neuropathic cancer pain and
fibromyalgia. Many patients and their physicians fail to realize the
neuropathic nature of some patients' pain, including severe burning, stinging,
and shooting pain. This general lack of awareness is largely due to the
complicated nature of the onset of NP, difficulty in confirming diagnoses, and
the lack of effective treatments.
An Opportunity to Meet Unmet Need for Therapy
By 2018, there will be approximately 6 million individuals in US suffering
from major NP conditions.
Given this substantial patient population, NP has received particular
attention in recent years due to its relative resistance to conventional
analgesic therapies. Importantly, many analgesic drugs, from nonsteroidal
anti-inflammatory drugs to strong opiates, have proven to be either
ineffective or to provide only limited relief. More pharmacological therapies
have been approved specifically for the treatment of NP in recent years.
There is still a great need to develop novel therapies that are safe and
effective. Recent research elucidating the mechanisms of NP has provided new
targets for pharmacological interventions that have captured the attention of
the pharmaceutical industry.
Report Objectives & Methodology
In this report WWMR, Inc., provides an overview for ten major conditions
causing NP in the US market.
This report also summarizes WWMR, Inc.' s current understanding of NP
mechanisms, and highlights promising targets for drug development. Also
reviewed are new treatments already in development that offer the promise of
improved pain management of NP in the near future.
Models representing patient populations and the commercial value (USD) of this
market in 2008, 2013, and 2018 are presented. These models describe the
important features of key conditions associated with NP:
- Neuropathic back pain
- Diabetic neuropathy
- Complex regional pain syndrome
- HIV/AIDS neuropathy
- Post-herpetic neuralgia
- Phantom limb pain
- Spinal cord injury
- Trigeminal neuralgia
- Fibromyalgia
- Neuropathic cancer pain
Expert analysis and commentary describing the future NP market are based on:
- WWMR' s Pain Clinic Monitor, profiling neuropathic pain conditions
- Comprehensive analysis of uses for specific conditions, including
estimations of prescription size, number of refills, and cost
- Evaluation of drugs in the NP drug pipeline, with conclusions on the
future directions in treatment
- In-depth analysis of the medical literature, including treatment review
articles, medical textbooks, epidemiology studies, and clinical studies
- Thorough review of country-specific and overall trends
Market and patient population forecasts are based on a consensus developed
from industry experience, clinician input, and analysis of secondary sources.
WWMR' s US Neuropathic Pain report will allow pharmaceutical and biotechnology executives to:
- Compare the epidemiology of neuropathic pain, including projected growth
rates, by indication
- Recognize the specific conditions associated with neuropathic pain that
have high market potential in the next 10 years
- Target specific patient populations who will benefit most from drugs in
the neuropathic pain pipeline
- Anticipate upcoming competitors and product licensing opportunities
- Understand the type and level of unmet need in the US neuropathic pain
market
- Recognize the impact of special market dynamics, including potential
off-label usage, on product uptake forecasts
About EP Publications
Enhance your perspective through EP Publications, a service of WWMR, Inc. Each
report pinpoints and evaluates key trends and markets, enabling clients to
identify opportunities and augment strategic decisions. In-house consultants
with industry experience use qualitative and quantitative research
methodologies to provide the most comprehensive and insightful business
intelligence available in the life sciences industry.
Table of Contents
NEW IN 2008
Two new indications:
- Fibromyalgia
- Neuropathic Cancer Pain
I. EXECUTIVE SUMMARY
II. INTRODUCTION AND METHODOLOGY
III. PHYSIOLOGY OF PAIN
- A. Definition of Neuropathic Pain
- 1. Nerve injury
- 2. Long duration
- 3. Abnormal sensations
- 4. Aggravation by physiological processes
- 5. Cellular mechanisms of neuropathic pain
- B. Definition of Neuropathic Pain States
- 1. Neuropathic low back pain
- 2. Diabetic neuropathy
- 3. Complex regional pain syndrome (CRPS)
- 4. Peripheral neuropathy in HIV/AIDS
- 5. Post-herpetic neuralgia
- 6. Phantom limb pain
- 7. Spinal cord injury
- 8. Trigeminal neuralgia (tic douloureux)
- 9. Cancer Pain
- 10. Fibromyalgia
IV. CLINICAL ASSESSMENT OF NEUROPATHIC PAIN
- 1. Qualitative description of pain
- 2. Standard quantitative pain measurement scales
- 3. Physical examination of the neuropathic pain patient
V. EPIDEMIOLOGY - CURRENT AND FUTURE
- A. Neuropathic Low-Back Pain
- 1. Low-back pain
- 2. Low-back pain incidence and prevalence
- 3. Chronic low-back pain prevalence
- 4. Neuropathic, chronic low-back pain prevalence
- 5. Basis of target population
- 6. US neuropathic, chronic low-back pain population forecasts
- B. Diabetic Neuropathy
- 1. Diabetic neuropathy
- 2. Diabetes prevalence
- 3. Diabetic neuropathy prevalence
- 4. Painful diabetic neuropathy prevalence
- 5. Moderate-to-severe diabetic neuropathic pain prevalence
- 6. Chronic moderate-to-severe diabetic neuropathic pain prevalence
- 7. Basis of target population forecasts
- 8. US diabetic neuropathy population forecasts
- C. Complex Regional Pain Syndrome
- 1. Complex regional pain syndrome
- 2. Complex regional pain syndrome prevalence
- 3. Complex regional pain syndrome severity
- 4. Basis of target population estimation
- 5. US CRPS population forecasts
- D. HIV/AIDS Neuropathic Pain
- 1. HIV/AIDS pain
- 2. AIDS incidence and prevalence
- 3. HIV (not AIDS) prevalence
- 4. HIV/AIDS pain prevalence
- 5. HIV/AIDS neuropathic pain prevalence
- 6. Basis of target population forecasts
- 7. US HIV/AIDS neuropathy population forecasts
- E. Post-Herpetic Neuralgia
- 1. Post-herpetic neuralgia
- 2. Herpes zoster incidence
- 3. Post-herpetic neuralgia incidence
- 4. Incidence of persistent post-herpetic neuralgia
- 5. Persistent post-herpetic neuralgia prevalence
- 6. Basis of target population forecasts
- 7. US post-herpetic neuralgia population forecasts
- F. Phantom Limb Pain
- 1. Phantom limb pain
- 2. Amputation incidence and prevalence
- 3. Phantom limb pain incidence and prevalence
- 4. Basis of target population estimation
- 5. US phantom limb pain population forecasts
- G. Spinal Cord Injury
- 1. Spinal cord injury
- 2. Spinal cord injury incidence
- 3. Spinal cord injury prevalence
- 4. Spinal cord injury chronic pain prevalence
- 5. Basis of target population estimation
- 6. US spinal cord injury population forecasts
- H. Trigeminal Neuralgia
- 1. Trigeminal neuralgia
- 2. Trigeminal neuralgia incidence and prevalence
- 3. Basis for target population
- 4. US trigeminal neuralgia population forecasts
- I. Neuropathic Cancer Pain
- 1. Cancer pain
- 2. Incidence of cancer
- 3. Incidence of neuropathic cancer pain
- 4. Prevalence of neuropathic cancer pain
- 5. Basis for target population
- 6. US Neuropathic cancer pain population forecasts
- J. Fibromyalgia
- 1. Fibromyalgia
- 2. Incidence of fibromyalgia
- 3. Prevalence of fibromyalgia
- 4. Diagnosed and treated population
- 5. Basis for target population
- 6. US fibromyalgia population forecasts
VI. APPROACHES TO TREATMENT OF NEUROPATHIC PAIN
- A. Actual Clinical Practice
- 1. Antidepressants
- 2. Anticonvulsants
- 3. Local anesthetics, regional nerve blocks, and sympathetic nerve blocks
- 4. Antiarrhythmics
- 5. Non-narcotic synthetic opioids
- 6. Opioids and semi-synthetic narcotics
- 7. Muscle relaxants
- 8. NMDA receptor antagonists
- 9. Steroids
- 10. VR-1 receptor agonists
- 11. Non-steroidal anti-inflammatory agents (NSAIDs)
- 12. Non-pharmacologic treatments
- B. Clinical Practice Guidelines
- C. Limitations of Current Treatment
- D. Promising New Approaches
- E. Future Trends
- F. Drugs in Clinical Development to Treat Neuropathic Pain
- 1. Recent launches/approvals
- 2. Current pipeline
- 2.1 Phase III, Preregistration, and Registration
- 2.2 Phase II
- 2.3 Phase I
- 2.4 Discontinued or suspended drugs
- 2.5 Marketed agents with significant off-label usage for NP
VII. MARKET FORECASTS AND ESTIMATES, CURRENT AND FUTURE
- A. Current Sales of Pharmaceutical Products, By Drug Class and
Condition
- 1. 2008 US market: summary by drug class
- 1.1 Anticonvulsants
- 1.2 Oral opioids
- 1.3 Antidepressants
- 1.4 Other drug classes
- 2. 2008 US market: summary by neuropathic pain condition
- 2.1 Fibromyalgia
- 2.2 Neuropathic back pain
- 2.3 Diabetic neuropathy (DN)
- 2.4 Neuropathic cancer pain
- 2.5 Post-herpetic neuralgia (PHN)
- 2.6 Complex regional pain syndrome (CRPS)
- 2.7 Trigeminal neuralgia (TN)
- 2.8 Phantom limb pain
- 2.9 HIV/AIDS neuropathic pain
- 2.10 Spinal cord injury
- Methodology
- B. Market Forecast for Neuropathic Pain
