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The Global Pain Therapeutics Market
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The Global Pain Therapeutics Market
4th Edition: Market Trends & R&D Insights
- Product Code:ARR00022
- Publication Date:November 2010
- Publisher:Arrowhead
- Product Type: Report
- Pages:400
The Global Pain Therapeutics Market 4th Edition: Market Trends & R&D Insights
Pain continues to present numerous challenges to the biopharmaceutical industry. According to the American Academy of Pain Medicine, over 76 million Americans suffer from pain. Indeed, pain affects more Americans than cancer, diabetes and cardiac disease combined. Current analgesics only provide modest relief, frequently carry black box safety warnings and are susceptible to abuse.
The anticipated arrival of novel analgesics is set to transform this market. GW Pharmaceuticals’ Sativex (GW-1000), Allergan’s Botox (botulinium toxin), Merck’s Telecagepant (MK-0974), Novartis’ Canakinumab (ACZ885) and FoldRX Pharma’s Tafamidis (meglumine) will modernize pain management strategies. The market will enter a highly competitive, transitional era following the COX-2 saga. Investors must differentiate their products to gain blockbuster sales witnessed by Pfizer’s Lyrica (pregabalin) and Celebrex (celecoxib).
With numerous unmet needs, improved diagnosis of painful conditions, the advent of pharmacogenomics driving R&D and 10% of the global population regularly taking analgesia; the pain therapeutics market offers numerous lucrative commercial opportunities.
This in-depth report...
- Analyzes seven major painful conditions examining epidemiology in the seven major markets, therapeutic management overview, unmet needs and pipeline analysis of each condition to maximize your product’s commercial success
- Identifies the major challenges within pain R&D trends; exploring unmet needs, pain clinical trials, pharmacogenomics, animal pain models and functional imaging techniques
- Analyzes both the clinical and commercial sides of the pain therapeutics market; including key late stage and Phase III/ II candidates and novel drug classes to watch
Report highlights
- Although the analgesia market is highly competitive and heavily genericized, growth is expected. Improved diagnosis of fibromyalgia and neuropathic pain will be key driving factors. Sales of pain therapeutics could reach a massive $59 billion by 2015 in the seven major markets.
- Biomarkers will transform pain R&D away from the traditional linear, over-simplified model approach. Novel analgesia drug targets will be realized, streamlining clinical trials and optimizing candidate’s efficacy and safety profiles.
- Opioids will continue to form the backbone of pain relief due to improved physician prescribing confidence. By 2015, sales of opioids could reach $17 billion, with OxyContin (oxycodone; Purdue) remaining the top-selling branded analgesic until its patent expiration in 2013.
Reasons to buy this report
- Assess opportunities and risks influencing pain R&D and regulatory approval trends
- Gain an impartial perspective of strategies that can be used to enhance your product’s performance in the pain therapeutics market
- Identify key pain therapeutic products in late-phase development
- Benchmark the competition via sales forecasts to 2015
1 Executive Summary
1.1 Scope of Global Pain Therapeutics Market, 4th Edition: Market Trends and R&D Insights
1.2 Methodology of Global Pain Therapeutics Market, 4th Edition: Market Trends and R&D Insights
1.3 The Epidemiology of Pain in the Seven Major Markets
1.4 Unmet Needs in the Pain Therapeutics Market
1.5 Pain Therapeutics Pipeline Analysis
1.6 Pain Therapeutics Market Analysis
2 Pain: Disease Background
2.1 An Introduction to Pain
2.2 The Classification of Pain
2.2.1 Acute Pain
2.2.2 Chronic Pain
2.3 The Pathophysiology of Pain
2.3.1 The Pain Pathway
2.3.2 The Modulation of the Pain Signal
2.3.3 Referred Pain
2.4 The Immune System and Pain
2.4.1 Nerve Growth Factor (NGF)
2.4.2 Brain Derived Neurotrophic Factor (BDNF)
2.4.3 Nitrous Oxide (NO)
2.4.4 Tumor Necrosis Factor (TNF)
2.4.5 Interleukin-1 (IL-1)
2.4.6 Glutamate
2.5 Pain and Genetics
2.6 The Subjective Nature of Pain
2.6.1 The Evaluation of Pain
2.7 The Global Impact of Pain
2.7.1 The Financial Impact of Pain
3 Managing Pain: WHO’s Pain Therapeutics Classes and Treatment Guidelines
3.1 Overview of the WHO’s Pain Therapeutics Classification
3.2 M01A Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
3.3 M01B Anti-Inflammatory/Anti-Rheumatic Agents in Combination
3.4 N01A General Anesthetics
3.5 N01B Local Anesthetics
3.6 N02A Narcotic Analgesics
3.7 N02B Non-Narcotic Analgesics
3.8 N02C Anti-Migraine Preparations
3.9 Arrowhead’s Analgesic Dug Classification System
3.10 WHO Pain Management Guidelines
4 The Postoperative Pain Market
4.1 Overview of Postoperative Pain
4.2 Epidemiology of Postoperative Pain
4.3 The Therapeutic Management of Postoperative Pain
4.3.1 Epidural Local Anesthetics Used in Postoperative Pain
4.3.2 Strong Opioids Used in Postoperative Pain
4.3.3 Weak Opioids Used in Postoperative Pain
4.3.4 NSAIDs Used in Postoperative Pain
4.3.5 Multi-Modal Analgesia Used in Postoperative Pain
4.4 Leading Brand Products in the Postoperative Pain Market
4.4.1 AstraZeneca/Abraxis BioScience’s Naropin (ropivacaine)
4.4.2 J&J’s/Ortho McNeil –Janssen Pharmaceuticals Duragesic (transdermal fentanyl)
4.5 Unmet Needs in the Postoperative Pain Market
4.6 Postoperative Pain Therapeutics Pipeline Analysis
4.6.1 Javelin Pharmaceuticals’ Dyloject (Dicofenac Injection)
4.6.2 Pfizer’s Lyrica (pregabalin)
4.6.3 Paion’s Morphine-6-Gluconaride (M6G, intravenous morphine)
4.7 Postoperative Pain Therapeutics Market Commentary
5 The Neuropathic Pain Market
5.1 Overview of Neuropathic Pain
5.2 Epidemiology of Neuropathic Pain
5.3 The Therapeutic Management of Neuropathic Pain
5.3.1 Topical Lidocaine Used in Neuropathic Pain
5.3.2 Antidepressants Used in Neuropathic Pain
5.3.3 Opioids Used in Neuropathic Pain
5.4 Leading Brand Products in the Neuropathic Pain Market
5.4.1 Endo Pharmaceuticals’ Lidoderm (lidocaine 5%)
5.4.2 Pfizer’s Lyrica (pregablin)
5.4.3 Eli Lilly’s Cymbalta (duloxetine)
5.4.4 Pfizer’s Neurontin (gabapentin)
5.4.5 Novartis’ Tegretol (carbamazepine)
5.5 Unmet Needs in the Neuropathic Pain Market
5.6 Neuropathic Pain Therapeutics Pipeline Analysis
5.6.1 NeurogesX/Astellas Pharma’s Qutenza (capsaicin 8% patch, NGX-4010)
5.6.2 EpiCepts’ EpiCept NP-1 (amitriptyline/ketamine)
5.6.3 FoldRx Pharmaceuticals’ Tafamidis meglumine (Fx-1006A)
5.6.4 Newron Pharmaceuticals’ Ralfinamide
5.7 Neuropathic Pain Therapeutics Market Commentary
6 The Fibromyalgia Market
6.1 Fibromyalgia Overview
6.2 Epidemiology of Fibromyalgia
6.3 The Therapeutic Management of Fibromyalgia Pain
6.3.1 Analgesics Used in Fibromyalgia
6.3.2 Antidepressants Used in Fibromyalgia
6.3.3 Muscle Relaxants Used in Fibromyalgia
6.3.4 Sleep Modifiers Used in Fibromyalgia
6.3.5 Anxiety Medications Used in Fibromyalgia
6.3.6 Anticonvulsants Used in Fibromyalgia
6.3.7 Antibiotics Used in Fibromyalgia
6.4 Leading Brands in the Fibromyalgia Pain Market
6.4.1 Pfizer’s Lyrica (pregabalin)
6.4.2 Forest Laboratories/Cypress BioScience’s Savella (milnacipran)
6.4.3 Eli Lilly’s Cymbalta (duloxetine)
6.5 Unmet Needs in Fibromyalgia Pain Market
6.6 Fibromyalgia Pain Pipeline Analysis
6.6.1 Jazz Pharmaceuticals/UCB’s JZP-6 (sodium oxybate)
6.7 Fibromyalgia Pain Market Commentary
7 The Arthritic Pain Market
7.1 Arthritis Overview
7.2 Epidemiology of Arthritic Pain
7.3 The Therapeutic Management of Arthritic Pain
7.3.1 Acetaminophen used in Arthritis
7.3.2 NSAIDs Used in Arthritis
7.3.3 COX-2 Inhibitors Used in Arthritis
7.3.4 Disease Modifying Anti-Rheumatic Drugs (DMARDs) Used in Arthritis
7.3.5 Biologic Disease Modifying Anti-inflammatory Drugs Used in Arthritis
7.3.6 Corticosteroids Used in Arthritis
7.3.7 Immunosuppressant’s used in Arthritis
7.4 Leading Brands in the Arthritic Pain Market
7.4.1 Pfizer Celebrex (celecoxib)
7.4.2 Pfizer’s Arthrotec (diclofenac/misprostol)
7.4.3 Boehringer Ingelheim/Abbott’s Mobic (meloxicam)
7.4.4 Pfizer’s DayPro (oxarprozin)
7.5 Unmet Needs in the Arthritic Pain Market
7.6 Arthritic Pain Therapeutic Pipeline Analysis
7.6.1 AstraZeneca/Pozen’s Vimovo (naproxen/esomeprazole)
7.6.2 Pain Therapeutics/King Pharmaceuticals/Duracet’s Remoxy (oxycodone)
7.6.3 Pfizer’s Tanezumab (PF-4383119)
7.6.4 Novartis’ Canakinumab (ACZ885)
7.6.5 Janssen-Ortho-McNeil/Grünenthal GmbH’s Nucynta (tapentadol)
7.7 Arthritic Pain Market Commentary
8 The Migraine Market
8.1 Migraine Overview
8.2 Epidemiology of Migraine
8.3 The Therapeutic Management of Migraine
8.3.1 Prophylactic Migraine Therapies
8.3.2 Basic Analgesics Used in Migraine
8.3.3 Ergot Alkaloid Derivatives Used in Migraine
8.3.4 Triptans Used in Migraine
8.3.5 Neuroleptics Used in Migraine
8.3.6 Beta-Blockers Used in Migraine
8.4 Leading Brand Products in the Migraine Market
8.4.1 GSK’s Imitrex/Imigran (sumatriptan)
8.4.2 AstraZeneca’s Zomig (zolmitriptan)
8.4.3 Merck’s Maxalt (rizartriptan)
8.4.4 Pfizer’s Relpax (eletriptan)
8.4.5 GSK/Pozen’s Treximet (sumatripatan/naproxen)
8.4.6 J&J/Ortho-McNeil’s Topamax (topiramate)
8.4.7 Abbott’s Depakote (divalproex)
8.5 Unmet Needs in the Migraine Market
8.6 Migraine Therapeutics Pipeline Analysis
8.6.1 Merck’s Telcagepant (MK-0974)
8.6.2 Allergan’s Botox (botulinium toxin)
8.6.3 MAP Pharmaceutical’s Levadex (MAP0004)
8.6.4 NuPathe’s Zelrix (transdermal sumatriptan)
8.7 Migraine Market Commentary
9 The Cancer Pain Market
9.1 Cancer Pain Overview
9.2 Epidemiology of Cancer Pain
9.3 The Therapeutic Management of Cancer Pain
9.3.1 Strong Opioids Used in Cancer Pain
9.3.2 Weak Opioids Used in Cancer Pain
9.3.3 NSAIDs and Acetaminophen Used in Cancer Pain
9.3.4 Adjuvants Used in Cancer Pain
9.4 Leading Brands in the Cancer Pain Market
9.4.1 Cephalon Actiq (oral transmucosal fentanyl citrate)
9.4.2 Cephalon’s Fentora (fentanyl buccal)
9.4.3 Purdue’s OxyContin (oxycodone)
9.5 Unmet Needs in the Cancer Pain Therapeutics Market
9.6 Cancer Pain Therapeutics Pipeline Analysis
9.6.1 Orexo/ProStrakan’s Abstral (fentanyl sublingual)
9.6.2 Archimedes Pharmaceuticals’ PecFent (nasal spray fentanyl)
9.6.3 GW Pharmaceuticals’ Sativex (GW-1000)
9.6.4 Wex Pharmaceuticals’ Tecin (tetrodotoxin)
9.7 Cancer Pain Therapeutics Market Commentary
10 The Back Pain Market
10.1 Back Pain Overview
10.2 Epidemiology of Back Pain
10.3 The Therapeutic Management of Back Pain
10.3.1 NSAIDs Used in Back Pain
10.3.2 Transdermal Patches Used in Back Pain
10.3.3 Local Anesthetics Used in Back Pain
10.3.4 Opioids Used in Back Pain
10.3.5 Tricyclic Antidepressants Used in Back Pain
10.3.6 Muscle Relaxants Used in Back Pain
10.3.7 Colchicine Used in Back Pain
10.3.8 Anticonvulsants Used in Back Pain
10.4 Leading Brand Products in the Back Pain Market
10.4.1 Bayer’s Aleve (naproxone)
10.4.2 Novartis’ Voltaren (diclofenac)
10.4.3 Wyeth/Pfizer’s Advil (ibuprofen)
10.4.4 BMS’ Efferalgan (acetaminophen)
10.4.5 Johnson &Johnson’s Tyenol (acetaminophen)
10.5 Unmet Needs in the Back Pain Market
10.6 Back Pain Pipeline Analysis
10.6.1 Janssen-Ortho-McNeil Grünenthal GmbH’s Nucynta (tapentadol)
10.6.2 Pfizer’s Tanzeumab
10.6.3 EpiCept’s LidoPAIN BP (liodocaine topical patch)
10.7 Back Pain Market Commentary
11 Pain Therapeutics Research and Development (R&D) Trends
11.1 Overview of Clinical Trials
11.1.1 Issues Surrounding the Design of Pain Therapeutic Clinical Trials
11.1.2 Patient Selection
11.1.3 Trial Duration
11.1.4 Trial Comparator Drug Choice
11.1.5 Trial End-Point
11.1.6 Response Rates
11.1.7 Quality of Life
11.1.8 Adverse Events
11.1.9 Biomarkers in R&D
11.1.10 Predictive Biomarkers as Clinical Trial Surrogate Endpoints
11.1.11 The Use of Biomarkers to Stratify Patients
11.1.12 CYP2D6 Variants
11.1.13 Potential Pain Biomarkers
11.1.14 Arrowhead’s Recommendations for Maximizing Pain Therapeutics R&D
11.2 Animal Pain Models
11.3 Experimental Pain Models in Healthy Humans
11.3.1 UV-B Pain Model
11.3.2 Heat/Capsaicin Sensitization and Intradermal Capsaicin Injection Models
11.3.3 Multi-Modal, Multi-Tissue Model
11.3.4 Quantitative Sensory Testing
11.4 Functional Imaging Techniques
11.4.1 Functional Magnetic Resonance Imaging (fMRI)
11.4.2 Positron Emission Tomography (PET)
11.4.3 Single-Photon Emission Computed Tomography (SPECT)
11.5 Laser Doppler Flowmetry (LDF)
11.6 Abuse Liability and Safety/ Risk Evaluation and Mitigation Strategy (REMS)
12 Unmet Needs in the Pain Therapeutics Market
12.1 Clinical Efficacy of Today’s’ Analgesics Need Improving
12.2 Safety Profiles of Current Pain Therapeutics are Often Unacceptable
12.3 Certain Pain Patient Populations are Neglected
12.4 Improved Dosing Regimens
12.5 Convenient Administration Routes
12.6 The Validity of Animal Pain Models
12.7 The Reliability of Pain Evaluation Models
13 Pain Therapeutics Pipeline Watch
13.1 Introduction to the Pain Therapeutics Pipeline
13.2 Targeted Therapies
13.2.1 Pfizer’s Tanezumab (PF-4383119)
13.3 Purinoreceptor (P2X3 Receptor) Antagonists
13.3.1 Afferent Pharmaceuticals P2X3 Program
13.4 Cannabinoids
13.4.1 Solvay Pharmaceuticals/Abbott’s Marinol (dronabinol)
13.4.2 Valeant /Meda Pharmaceutical’s Cesamet (nabilone)
13.4.3 Sanofi-Aventis’ Acomplia /Zimulti (rimonabant)
13.4.4 GW Pharmaceuticals’ Sativex (GW-1000)
13.5 Ion Channels
13.5.1 Sodium Channel Blockers
13.5.2 Wex Pharmaceuticals’ Tectin (tetrodotoxin)
13.6 Glutamate Receptor Antagonists
13.7 NMDA-Receptor Antagonists
13.7.1 King Pharmaceuticals/Forest Laboratories/Richter’s RGH-896
13.8 NDMA and Opioid Receptor Overlap
13.9 Dual Mu-Opioid Agonist and Nor epinephrine Reuptake Inhibitors
13.9.1 Ortho-McNeil/Janssen Pharmaceuticals/Grünenthal GmbH’s Nucynta (tapentadol extended release)
13.10 Calcitonin-Gene-Related Peptide (CGRP) Receptor Antagonists
13.10.1 Merck’s Telcagepant (MK-0974)
13.11 Pipeline Agents Designed with Convenient Administration Routes
13.11.1 RoxRo Pharma Intranasal Ketorolac (ROX-888)
13.11.2 NovaDel’s NovaMist Technology
13.11.3 Depomed’s AcuForm Technology
13.11.4 Durect Corp’s Transdur Technology
13.11.5 Altea Therapeutics’ Hydromorphone Patches
14 Analysis of the Pain Therapeutic Market
14.1 Summary of Arrowhead’s Pain Therapeutics Analysis, 2010
14.2 Leading Pain Therapeutic Products of 2009
14.3 Leading Pain Therapeutics Drug Classes of 2010
14.4 Leading Pain Therapeutics Drug Class Products of 2010
14.4.1 COX-2 Inhibitors: Pfizer’s Celebrex (celecoxib)
14.4.2 NSAIDs: Novartis’ Voltaren (diclofenac)
14.4.3 Local Anesthetics: Endo Pharmaceutical’s Lidoderm (lidocaine 5% patch)
14.4.4 Narcotics: Purdue’s OxyContin (oxycodone)
14.4.5 Triptans: GSK’s Imitrex/Imigran (sumatriptan)
14.4.6 Nontraditional: Pfizer’s Lyrica (pregabalin)
14.5 Pfizer: Arrowhead’s Leading Pain Therapeutics Company of 2009/2010
14.6 SWOT Analysis of the Pain Therapeutics Market, 2010
14.7 Financial Forecast of the Pain Therapeutics Market
14.7.1 Financial Forecast of the Branded Pain Therapeutic Market
14.7.2 Arrowhead’s NSAID Market Outlook
14.7.3 Arrowhead’s COX-2 Market Outlook
14.7.4 Arrowhead’s Opioid Market Outlook
14.7.5 Arrowhead’s Triptan Market Outlook
14.7.6 Arrowhead’s Non-Traditional/Adjuvant Market Outlook
14.7.7 Arrowhead’s Local Anesthetics Market Outlook
14.8 Summary of the Future Global Pain Therapeutic Market
15 Bibliography
Tables
Table 1: Pain Incidence Forecast in the Seven Major Markets, 2008-2020
Table 2: Current Late Stage Pain Therapeutics Pipeline, June 2010
Table 3: Comparison of the Global Pain Therapeutics Market ($m) Revenue by Analgesic Class, 2010 and 2015
Table 4: Characteristics and Treatment of Acute versus Chronic Pain
Table 5: Heritability Link in a Range of Diseases where Pain is a Predominant Factor
Table 6: Incidence of Pain Compared to Other Major Conditions in the US
Table 7: Incidence of Painful Conditions in US Households
Table 8: WHO Guidelines for Pain Management
Table 9: Surgery Incidence Forecast in the Seven Major Markets, 2008-2020
Table 10: Postoperative Acute Pain Incidence Forecast in the Seven Major Markets, 2008-2020
Table 11: Late-Stage and Phase II Postoperative Pain Therapeutics Pipeline, 2010
Table 12: Common Etiologies Associated with Neuropathic Pain
Table 13: Neuropathic Pain Incidence Forecast in the Seven Major Markets, 2008-2020
Table 14: Neuropathic Pain Therapeutics
Table 15: Late-Stage and Phase II Neuropathic Pain Therapeutics Pipeline, 2010
Table 16: Fibromyalgia Incidence Forecast in the Seven Major Markets, 2008-2020
Table 17: Late-Stage and Phase II Fibromyalgia Pain Therapeutics Pipeline, 2010
Table 18: Arthritis Incidence Forecast in the Seven Major Markets, 2008-2020
Table 19: Late-Stage and Phase II Arthritic Pain Therapeutics Pipeline, 2010
Table 20: Incidence Rate of Migraine (%) by Gender in the Seven Major Markets, 2010
Table 21: Migraine Incidence Forecast in the Seven Major Markets, 2008-2020
Table 22: Common Analgesics Used for Mild Migraine
Table 23: Ergot Alkaloid Derivatives Used for Migraine
Table 24: Triptans Used for Migraine
Table 25: Late-Stage and Phase Migraine Pain Therapeutics Pipeline, 2010
Table 26: Crude Incidence Rate of Cancer by Gender in the Seven Major Markets, 2010
Table 27: Cancer Incidence Forecast in the Seven Major Markets, 2008-2020
Table 28: Cancer Pain Incidence Forecast in the Seven Major Markets, 2008-2020
Table 29: The Oral and Paraental Equivalences and Relative Potency of Opioids Compared with Morphine
Table 30: Adjuvant Therapeutics Used in Cancer Pain Management
Table 31: Late-Stage and Phase II Cancer Pain Therapeutics Pipeline, 2010
Table 32: Low Back Pain Incidence Forecast in the Seven Major Markets, 2008-2020
Table 33: Late-Stage and Phase II Back Pain Therapeutics Pipeline, 2010
Table 34: Potential Pain Biomarkers
Table 35: Pain Therapeutics Investigated by fMRI
Table 36: Current Late Stage and II Pain Therapeutics Pipeline, June 2010
Table 37: Summary of Branded Analgesics Analyzed by Arrowhead Publishers, 2010
Table 38: Top-10 Selling Branded Analgesics, 2009 Revenues ($m)
Table 39: Revenues of the 2009 and 2008 Top-Selling Analgesics by Drug Classification ($m)
Table 40: Worldwide Leading Branded Pain Therapeutic Revenue History ($m), 2004-2009
Table 41: Summary of Arrowhead’s Key Pipeline Pain Therapeutics Candidates, 2010
Table 42: Worldwide Leading Branded Pain Therapeutic Revenue Forecast ($m), 2010-2015
Table 43: Financial Forecast of the NSAID Global Market ($m), 2009-2015
Table 44: Financial Forecast of the COX-2 Global Market ($m), 2009-2015
Table 45: Financial Forecast of the Opioid Global Market ($m), 2009-2015
Table 46: Financial Forecast of the Triptan Global Market ($m), 2009-2015
Table 47: Financial Forecast of the Nontraditional/Adjuvant Global Market ($m), 2009-2015
Table 48: Financial Forecast of Local Anesthetics Global Market ($m), 2009-2015
Table 49: Total Global Pain Therapeutic Market Forecast ($m) by Drug Class, 2009-2015
Figures
Figure1: Pain Incidence Forecast in the Seven Major Markets, 2008-2020
Figure 2: Pain Incidence Forecast in the Seven Major Markets, 2010 and 2020
Figure 3: Unmet Needs in the Pain Therapeutics Market 26
Figure 4: Analgesic Drug Classes Share of the Global Pain Therapeutics Market, 2010
Figure 5: Analgesic Drug Classes Share of the Global Pain Therapeutics Market, 2015
Figure 6: Schematic Diagram of the Pain Pathway
Figure 7: Schematic Diagram of Referred Pain Pathways Involved in an Ischemic Cardiac Attack
Figure 8: Schematic Diagram of Variability of Genes at Multiple Sites of the Pain Pathway Contributing to Individual Differences in Pain Processing
Figure 9: Examples of Pain Evaluation Models
Figure 10: Leading Causes of Pain in the US
Figure 11: Surgery Incidence Forecast in the Seven Major Markets, 2008-2020
Figure 12: Postoperative Acute Pain Incidence Forecast in the Seven Major Markets, 2008-2020
Figure 13: World Federation of Societies of Anesthesiologists (WFSA) Analgesic Ladder
Figure 14: PROSPECT Postoperative Pain Management Algorithm
Figure 15: Neuropathic Pain Incidence Forecast in the Seven Major Markets, 2008-2020
Figure 16: NIH Algorithm for Managing Neuropathic Pain
Figure 17: Fibromyalgia Painful Points within the Human Body
Figure 18: Fibromyalgia Incidence Forecast in the Seven Major Markets, 2008-2020
Figure 19: Treatment Algorithm for Fibromyalgia
Figure 20: Arthritis Incidence Forecast in the Seven Major Markets, 2008-2020
Figure 21: Arthritis Therapeutic Treatment Algorithm
Figure 22: Migraine Incidence Forecast in the Seven Major Markets, 2008-2020
Figure 23: European Federation of Neurological Societies (EFNS) 2009 Migraine Treatment Algorithm
Figure 24: Cancer Incidence Forecast in the Seven Major Markets, 2008-2020
Figure 25: Cancer Pain Incidence Forecast in the Seven Major Markets, 2008-2020
Figure 26: WHO’s Three-Step ‘Analgesia Ladder’ for Cancer Pain Management
Figure 27: Low Back Pain Incidence Forecast in the Seven Major Markets, 2008-2020
Figure 28: Back Pain Treatment Algorithm
Figure 29: LidoPAIN BP’s Phase IIa Back Pain Trial Results
Figure 30: Schematic Diagram of Blood Oxygenation Level Dependent (BOLD) Concept in MRI
Figure 31: SWOT Analysis of the Pain Therapeutics Market, 2010
Figure 32: Worldwide Leading Branded Pain Therapeutic Revenue Forecast ($m), 2004-2015
Figure 33: Financial Forecast of the NSAID Global Market ($m), 2009-2015
Figure 34: Financial Forecast of the COX-2 Global Market ($m), 2009-2015
Figure 35: Financial Forecast of the Opioid Global Market ($m), 2009-2015
Figure 36: Financial Forecast of the Triptan Global Market ($m), 2009-2015
Figure 37: Financial Forecast of the Nontraditional/Adjuvant Global Market ($m), 2009-2015
Figure 38: Financial Forecast of Local Anesthetics Global Market ($m), 2009-2015
Figure 39: Total Global Pain Therapeutics Market Forecast ($m) by Drug Class, 2009-2015
Figure 40: Total Global Pain Therapeutics Market Revenue Forecast ($m), 2009-2015
1.1 Scope of Global Pain Therapeutics Market, 4th Edition: Market Trends and R&D Insights
1.2 Methodology of Global Pain Therapeutics Market, 4th Edition: Market Trends and R&D Insights
1.3 The Epidemiology of Pain in the Seven Major Markets
1.4 Unmet Needs in the Pain Therapeutics Market
1.5 Pain Therapeutics Pipeline Analysis
1.6 Pain Therapeutics Market Analysis
2 Pain: Disease Background
2.1 An Introduction to Pain
2.2 The Classification of Pain
2.2.1 Acute Pain
2.2.2 Chronic Pain
2.3 The Pathophysiology of Pain
2.3.1 The Pain Pathway
2.3.2 The Modulation of the Pain Signal
2.3.3 Referred Pain
2.4 The Immune System and Pain
2.4.1 Nerve Growth Factor (NGF)
2.4.2 Brain Derived Neurotrophic Factor (BDNF)
2.4.3 Nitrous Oxide (NO)
2.4.4 Tumor Necrosis Factor (TNF)
2.4.5 Interleukin-1 (IL-1)
2.4.6 Glutamate
2.5 Pain and Genetics
2.6 The Subjective Nature of Pain
2.6.1 The Evaluation of Pain
2.7 The Global Impact of Pain
2.7.1 The Financial Impact of Pain
3 Managing Pain: WHO’s Pain Therapeutics Classes and Treatment Guidelines
3.1 Overview of the WHO’s Pain Therapeutics Classification
3.2 M01A Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
3.3 M01B Anti-Inflammatory/Anti-Rheumatic Agents in Combination
3.4 N01A General Anesthetics
3.5 N01B Local Anesthetics
3.6 N02A Narcotic Analgesics
3.7 N02B Non-Narcotic Analgesics
3.8 N02C Anti-Migraine Preparations
3.9 Arrowhead’s Analgesic Dug Classification System
3.10 WHO Pain Management Guidelines
4 The Postoperative Pain Market
4.1 Overview of Postoperative Pain
4.2 Epidemiology of Postoperative Pain
4.3 The Therapeutic Management of Postoperative Pain
4.3.1 Epidural Local Anesthetics Used in Postoperative Pain
4.3.2 Strong Opioids Used in Postoperative Pain
4.3.3 Weak Opioids Used in Postoperative Pain
4.3.4 NSAIDs Used in Postoperative Pain
4.3.5 Multi-Modal Analgesia Used in Postoperative Pain
4.4 Leading Brand Products in the Postoperative Pain Market
4.4.1 AstraZeneca/Abraxis BioScience’s Naropin (ropivacaine)
4.4.2 J&J’s/Ortho McNeil –Janssen Pharmaceuticals Duragesic (transdermal fentanyl)
4.5 Unmet Needs in the Postoperative Pain Market
4.6 Postoperative Pain Therapeutics Pipeline Analysis
4.6.1 Javelin Pharmaceuticals’ Dyloject (Dicofenac Injection)
4.6.2 Pfizer’s Lyrica (pregabalin)
4.6.3 Paion’s Morphine-6-Gluconaride (M6G, intravenous morphine)
4.7 Postoperative Pain Therapeutics Market Commentary
5 The Neuropathic Pain Market
5.1 Overview of Neuropathic Pain
5.2 Epidemiology of Neuropathic Pain
5.3 The Therapeutic Management of Neuropathic Pain
5.3.1 Topical Lidocaine Used in Neuropathic Pain
5.3.2 Antidepressants Used in Neuropathic Pain
5.3.3 Opioids Used in Neuropathic Pain
5.4 Leading Brand Products in the Neuropathic Pain Market
5.4.1 Endo Pharmaceuticals’ Lidoderm (lidocaine 5%)
5.4.2 Pfizer’s Lyrica (pregablin)
5.4.3 Eli Lilly’s Cymbalta (duloxetine)
5.4.4 Pfizer’s Neurontin (gabapentin)
5.4.5 Novartis’ Tegretol (carbamazepine)
5.5 Unmet Needs in the Neuropathic Pain Market
5.6 Neuropathic Pain Therapeutics Pipeline Analysis
5.6.1 NeurogesX/Astellas Pharma’s Qutenza (capsaicin 8% patch, NGX-4010)
5.6.2 EpiCepts’ EpiCept NP-1 (amitriptyline/ketamine)
5.6.3 FoldRx Pharmaceuticals’ Tafamidis meglumine (Fx-1006A)
5.6.4 Newron Pharmaceuticals’ Ralfinamide
5.7 Neuropathic Pain Therapeutics Market Commentary
6 The Fibromyalgia Market
6.1 Fibromyalgia Overview
6.2 Epidemiology of Fibromyalgia
6.3 The Therapeutic Management of Fibromyalgia Pain
6.3.1 Analgesics Used in Fibromyalgia
6.3.2 Antidepressants Used in Fibromyalgia
6.3.3 Muscle Relaxants Used in Fibromyalgia
6.3.4 Sleep Modifiers Used in Fibromyalgia
6.3.5 Anxiety Medications Used in Fibromyalgia
6.3.6 Anticonvulsants Used in Fibromyalgia
6.3.7 Antibiotics Used in Fibromyalgia
6.4 Leading Brands in the Fibromyalgia Pain Market
6.4.1 Pfizer’s Lyrica (pregabalin)
6.4.2 Forest Laboratories/Cypress BioScience’s Savella (milnacipran)
6.4.3 Eli Lilly’s Cymbalta (duloxetine)
6.5 Unmet Needs in Fibromyalgia Pain Market
6.6 Fibromyalgia Pain Pipeline Analysis
6.6.1 Jazz Pharmaceuticals/UCB’s JZP-6 (sodium oxybate)
6.7 Fibromyalgia Pain Market Commentary
7 The Arthritic Pain Market
7.1 Arthritis Overview
7.2 Epidemiology of Arthritic Pain
7.3 The Therapeutic Management of Arthritic Pain
7.3.1 Acetaminophen used in Arthritis
7.3.2 NSAIDs Used in Arthritis
7.3.3 COX-2 Inhibitors Used in Arthritis
7.3.4 Disease Modifying Anti-Rheumatic Drugs (DMARDs) Used in Arthritis
7.3.5 Biologic Disease Modifying Anti-inflammatory Drugs Used in Arthritis
7.3.6 Corticosteroids Used in Arthritis
7.3.7 Immunosuppressant’s used in Arthritis
7.4 Leading Brands in the Arthritic Pain Market
7.4.1 Pfizer Celebrex (celecoxib)
7.4.2 Pfizer’s Arthrotec (diclofenac/misprostol)
7.4.3 Boehringer Ingelheim/Abbott’s Mobic (meloxicam)
7.4.4 Pfizer’s DayPro (oxarprozin)
7.5 Unmet Needs in the Arthritic Pain Market
7.6 Arthritic Pain Therapeutic Pipeline Analysis
7.6.1 AstraZeneca/Pozen’s Vimovo (naproxen/esomeprazole)
7.6.2 Pain Therapeutics/King Pharmaceuticals/Duracet’s Remoxy (oxycodone)
7.6.3 Pfizer’s Tanezumab (PF-4383119)
7.6.4 Novartis’ Canakinumab (ACZ885)
7.6.5 Janssen-Ortho-McNeil/Grünenthal GmbH’s Nucynta (tapentadol)
7.7 Arthritic Pain Market Commentary
8 The Migraine Market
8.1 Migraine Overview
8.2 Epidemiology of Migraine
8.3 The Therapeutic Management of Migraine
8.3.1 Prophylactic Migraine Therapies
8.3.2 Basic Analgesics Used in Migraine
8.3.3 Ergot Alkaloid Derivatives Used in Migraine
8.3.4 Triptans Used in Migraine
8.3.5 Neuroleptics Used in Migraine
8.3.6 Beta-Blockers Used in Migraine
8.4 Leading Brand Products in the Migraine Market
8.4.1 GSK’s Imitrex/Imigran (sumatriptan)
8.4.2 AstraZeneca’s Zomig (zolmitriptan)
8.4.3 Merck’s Maxalt (rizartriptan)
8.4.4 Pfizer’s Relpax (eletriptan)
8.4.5 GSK/Pozen’s Treximet (sumatripatan/naproxen)
8.4.6 J&J/Ortho-McNeil’s Topamax (topiramate)
8.4.7 Abbott’s Depakote (divalproex)
8.5 Unmet Needs in the Migraine Market
8.6 Migraine Therapeutics Pipeline Analysis
8.6.1 Merck’s Telcagepant (MK-0974)
8.6.2 Allergan’s Botox (botulinium toxin)
8.6.3 MAP Pharmaceutical’s Levadex (MAP0004)
8.6.4 NuPathe’s Zelrix (transdermal sumatriptan)
8.7 Migraine Market Commentary
9 The Cancer Pain Market
9.1 Cancer Pain Overview
9.2 Epidemiology of Cancer Pain
9.3 The Therapeutic Management of Cancer Pain
9.3.1 Strong Opioids Used in Cancer Pain
9.3.2 Weak Opioids Used in Cancer Pain
9.3.3 NSAIDs and Acetaminophen Used in Cancer Pain
9.3.4 Adjuvants Used in Cancer Pain
9.4 Leading Brands in the Cancer Pain Market
9.4.1 Cephalon Actiq (oral transmucosal fentanyl citrate)
9.4.2 Cephalon’s Fentora (fentanyl buccal)
9.4.3 Purdue’s OxyContin (oxycodone)
9.5 Unmet Needs in the Cancer Pain Therapeutics Market
9.6 Cancer Pain Therapeutics Pipeline Analysis
9.6.1 Orexo/ProStrakan’s Abstral (fentanyl sublingual)
9.6.2 Archimedes Pharmaceuticals’ PecFent (nasal spray fentanyl)
9.6.3 GW Pharmaceuticals’ Sativex (GW-1000)
9.6.4 Wex Pharmaceuticals’ Tecin (tetrodotoxin)
9.7 Cancer Pain Therapeutics Market Commentary
10 The Back Pain Market
10.1 Back Pain Overview
10.2 Epidemiology of Back Pain
10.3 The Therapeutic Management of Back Pain
10.3.1 NSAIDs Used in Back Pain
10.3.2 Transdermal Patches Used in Back Pain
10.3.3 Local Anesthetics Used in Back Pain
10.3.4 Opioids Used in Back Pain
10.3.5 Tricyclic Antidepressants Used in Back Pain
10.3.6 Muscle Relaxants Used in Back Pain
10.3.7 Colchicine Used in Back Pain
10.3.8 Anticonvulsants Used in Back Pain
10.4 Leading Brand Products in the Back Pain Market
10.4.1 Bayer’s Aleve (naproxone)
10.4.2 Novartis’ Voltaren (diclofenac)
10.4.3 Wyeth/Pfizer’s Advil (ibuprofen)
10.4.4 BMS’ Efferalgan (acetaminophen)
10.4.5 Johnson &Johnson’s Tyenol (acetaminophen)
10.5 Unmet Needs in the Back Pain Market
10.6 Back Pain Pipeline Analysis
10.6.1 Janssen-Ortho-McNeil Grünenthal GmbH’s Nucynta (tapentadol)
10.6.2 Pfizer’s Tanzeumab
10.6.3 EpiCept’s LidoPAIN BP (liodocaine topical patch)
10.7 Back Pain Market Commentary
11 Pain Therapeutics Research and Development (R&D) Trends
11.1 Overview of Clinical Trials
11.1.1 Issues Surrounding the Design of Pain Therapeutic Clinical Trials
11.1.2 Patient Selection
11.1.3 Trial Duration
11.1.4 Trial Comparator Drug Choice
11.1.5 Trial End-Point
11.1.6 Response Rates
11.1.7 Quality of Life
11.1.8 Adverse Events
11.1.9 Biomarkers in R&D
11.1.10 Predictive Biomarkers as Clinical Trial Surrogate Endpoints
11.1.11 The Use of Biomarkers to Stratify Patients
11.1.12 CYP2D6 Variants
11.1.13 Potential Pain Biomarkers
11.1.14 Arrowhead’s Recommendations for Maximizing Pain Therapeutics R&D
11.2 Animal Pain Models
11.3 Experimental Pain Models in Healthy Humans
11.3.1 UV-B Pain Model
11.3.2 Heat/Capsaicin Sensitization and Intradermal Capsaicin Injection Models
11.3.3 Multi-Modal, Multi-Tissue Model
11.3.4 Quantitative Sensory Testing
11.4 Functional Imaging Techniques
11.4.1 Functional Magnetic Resonance Imaging (fMRI)
11.4.2 Positron Emission Tomography (PET)
11.4.3 Single-Photon Emission Computed Tomography (SPECT)
11.5 Laser Doppler Flowmetry (LDF)
11.6 Abuse Liability and Safety/ Risk Evaluation and Mitigation Strategy (REMS)
12 Unmet Needs in the Pain Therapeutics Market
12.1 Clinical Efficacy of Today’s’ Analgesics Need Improving
12.2 Safety Profiles of Current Pain Therapeutics are Often Unacceptable
12.3 Certain Pain Patient Populations are Neglected
12.4 Improved Dosing Regimens
12.5 Convenient Administration Routes
12.6 The Validity of Animal Pain Models
12.7 The Reliability of Pain Evaluation Models
13 Pain Therapeutics Pipeline Watch
13.1 Introduction to the Pain Therapeutics Pipeline
13.2 Targeted Therapies
13.2.1 Pfizer’s Tanezumab (PF-4383119)
13.3 Purinoreceptor (P2X3 Receptor) Antagonists
13.3.1 Afferent Pharmaceuticals P2X3 Program
13.4 Cannabinoids
13.4.1 Solvay Pharmaceuticals/Abbott’s Marinol (dronabinol)
13.4.2 Valeant /Meda Pharmaceutical’s Cesamet (nabilone)
13.4.3 Sanofi-Aventis’ Acomplia /Zimulti (rimonabant)
13.4.4 GW Pharmaceuticals’ Sativex (GW-1000)
13.5 Ion Channels
13.5.1 Sodium Channel Blockers
13.5.2 Wex Pharmaceuticals’ Tectin (tetrodotoxin)
13.6 Glutamate Receptor Antagonists
13.7 NMDA-Receptor Antagonists
13.7.1 King Pharmaceuticals/Forest Laboratories/Richter’s RGH-896
13.8 NDMA and Opioid Receptor Overlap
13.9 Dual Mu-Opioid Agonist and Nor epinephrine Reuptake Inhibitors
13.9.1 Ortho-McNeil/Janssen Pharmaceuticals/Grünenthal GmbH’s Nucynta (tapentadol extended release)
13.10 Calcitonin-Gene-Related Peptide (CGRP) Receptor Antagonists
13.10.1 Merck’s Telcagepant (MK-0974)
13.11 Pipeline Agents Designed with Convenient Administration Routes
13.11.1 RoxRo Pharma Intranasal Ketorolac (ROX-888)
13.11.2 NovaDel’s NovaMist Technology
13.11.3 Depomed’s AcuForm Technology
13.11.4 Durect Corp’s Transdur Technology
13.11.5 Altea Therapeutics’ Hydromorphone Patches
14 Analysis of the Pain Therapeutic Market
14.1 Summary of Arrowhead’s Pain Therapeutics Analysis, 2010
14.2 Leading Pain Therapeutic Products of 2009
14.3 Leading Pain Therapeutics Drug Classes of 2010
14.4 Leading Pain Therapeutics Drug Class Products of 2010
14.4.1 COX-2 Inhibitors: Pfizer’s Celebrex (celecoxib)
14.4.2 NSAIDs: Novartis’ Voltaren (diclofenac)
14.4.3 Local Anesthetics: Endo Pharmaceutical’s Lidoderm (lidocaine 5% patch)
14.4.4 Narcotics: Purdue’s OxyContin (oxycodone)
14.4.5 Triptans: GSK’s Imitrex/Imigran (sumatriptan)
14.4.6 Nontraditional: Pfizer’s Lyrica (pregabalin)
14.5 Pfizer: Arrowhead’s Leading Pain Therapeutics Company of 2009/2010
14.6 SWOT Analysis of the Pain Therapeutics Market, 2010
14.7 Financial Forecast of the Pain Therapeutics Market
14.7.1 Financial Forecast of the Branded Pain Therapeutic Market
14.7.2 Arrowhead’s NSAID Market Outlook
14.7.3 Arrowhead’s COX-2 Market Outlook
14.7.4 Arrowhead’s Opioid Market Outlook
14.7.5 Arrowhead’s Triptan Market Outlook
14.7.6 Arrowhead’s Non-Traditional/Adjuvant Market Outlook
14.7.7 Arrowhead’s Local Anesthetics Market Outlook
14.8 Summary of the Future Global Pain Therapeutic Market
15 Bibliography
Tables
Table 1: Pain Incidence Forecast in the Seven Major Markets, 2008-2020
Table 2: Current Late Stage Pain Therapeutics Pipeline, June 2010
Table 3: Comparison of the Global Pain Therapeutics Market ($m) Revenue by Analgesic Class, 2010 and 2015
Table 4: Characteristics and Treatment of Acute versus Chronic Pain
Table 5: Heritability Link in a Range of Diseases where Pain is a Predominant Factor
Table 6: Incidence of Pain Compared to Other Major Conditions in the US
Table 7: Incidence of Painful Conditions in US Households
Table 8: WHO Guidelines for Pain Management
Table 9: Surgery Incidence Forecast in the Seven Major Markets, 2008-2020
Table 10: Postoperative Acute Pain Incidence Forecast in the Seven Major Markets, 2008-2020
Table 11: Late-Stage and Phase II Postoperative Pain Therapeutics Pipeline, 2010
Table 12: Common Etiologies Associated with Neuropathic Pain
Table 13: Neuropathic Pain Incidence Forecast in the Seven Major Markets, 2008-2020
Table 14: Neuropathic Pain Therapeutics
Table 15: Late-Stage and Phase II Neuropathic Pain Therapeutics Pipeline, 2010
Table 16: Fibromyalgia Incidence Forecast in the Seven Major Markets, 2008-2020
Table 17: Late-Stage and Phase II Fibromyalgia Pain Therapeutics Pipeline, 2010
Table 18: Arthritis Incidence Forecast in the Seven Major Markets, 2008-2020
Table 19: Late-Stage and Phase II Arthritic Pain Therapeutics Pipeline, 2010
Table 20: Incidence Rate of Migraine (%) by Gender in the Seven Major Markets, 2010
Table 21: Migraine Incidence Forecast in the Seven Major Markets, 2008-2020
Table 22: Common Analgesics Used for Mild Migraine
Table 23: Ergot Alkaloid Derivatives Used for Migraine
Table 24: Triptans Used for Migraine
Table 25: Late-Stage and Phase Migraine Pain Therapeutics Pipeline, 2010
Table 26: Crude Incidence Rate of Cancer by Gender in the Seven Major Markets, 2010
Table 27: Cancer Incidence Forecast in the Seven Major Markets, 2008-2020
Table 28: Cancer Pain Incidence Forecast in the Seven Major Markets, 2008-2020
Table 29: The Oral and Paraental Equivalences and Relative Potency of Opioids Compared with Morphine
Table 30: Adjuvant Therapeutics Used in Cancer Pain Management
Table 31: Late-Stage and Phase II Cancer Pain Therapeutics Pipeline, 2010
Table 32: Low Back Pain Incidence Forecast in the Seven Major Markets, 2008-2020
Table 33: Late-Stage and Phase II Back Pain Therapeutics Pipeline, 2010
Table 34: Potential Pain Biomarkers
Table 35: Pain Therapeutics Investigated by fMRI
Table 36: Current Late Stage and II Pain Therapeutics Pipeline, June 2010
Table 37: Summary of Branded Analgesics Analyzed by Arrowhead Publishers, 2010
Table 38: Top-10 Selling Branded Analgesics, 2009 Revenues ($m)
Table 39: Revenues of the 2009 and 2008 Top-Selling Analgesics by Drug Classification ($m)
Table 40: Worldwide Leading Branded Pain Therapeutic Revenue History ($m), 2004-2009
Table 41: Summary of Arrowhead’s Key Pipeline Pain Therapeutics Candidates, 2010
Table 42: Worldwide Leading Branded Pain Therapeutic Revenue Forecast ($m), 2010-2015
Table 43: Financial Forecast of the NSAID Global Market ($m), 2009-2015
Table 44: Financial Forecast of the COX-2 Global Market ($m), 2009-2015
Table 45: Financial Forecast of the Opioid Global Market ($m), 2009-2015
Table 46: Financial Forecast of the Triptan Global Market ($m), 2009-2015
Table 47: Financial Forecast of the Nontraditional/Adjuvant Global Market ($m), 2009-2015
Table 48: Financial Forecast of Local Anesthetics Global Market ($m), 2009-2015
Table 49: Total Global Pain Therapeutic Market Forecast ($m) by Drug Class, 2009-2015
Figures
Figure1: Pain Incidence Forecast in the Seven Major Markets, 2008-2020
Figure 2: Pain Incidence Forecast in the Seven Major Markets, 2010 and 2020
Figure 3: Unmet Needs in the Pain Therapeutics Market 26
Figure 4: Analgesic Drug Classes Share of the Global Pain Therapeutics Market, 2010
Figure 5: Analgesic Drug Classes Share of the Global Pain Therapeutics Market, 2015
Figure 6: Schematic Diagram of the Pain Pathway
Figure 7: Schematic Diagram of Referred Pain Pathways Involved in an Ischemic Cardiac Attack
Figure 8: Schematic Diagram of Variability of Genes at Multiple Sites of the Pain Pathway Contributing to Individual Differences in Pain Processing
Figure 9: Examples of Pain Evaluation Models
Figure 10: Leading Causes of Pain in the US
Figure 11: Surgery Incidence Forecast in the Seven Major Markets, 2008-2020
Figure 12: Postoperative Acute Pain Incidence Forecast in the Seven Major Markets, 2008-2020
Figure 13: World Federation of Societies of Anesthesiologists (WFSA) Analgesic Ladder
Figure 14: PROSPECT Postoperative Pain Management Algorithm
Figure 15: Neuropathic Pain Incidence Forecast in the Seven Major Markets, 2008-2020
Figure 16: NIH Algorithm for Managing Neuropathic Pain
Figure 17: Fibromyalgia Painful Points within the Human Body
Figure 18: Fibromyalgia Incidence Forecast in the Seven Major Markets, 2008-2020
Figure 19: Treatment Algorithm for Fibromyalgia
Figure 20: Arthritis Incidence Forecast in the Seven Major Markets, 2008-2020
Figure 21: Arthritis Therapeutic Treatment Algorithm
Figure 22: Migraine Incidence Forecast in the Seven Major Markets, 2008-2020
Figure 23: European Federation of Neurological Societies (EFNS) 2009 Migraine Treatment Algorithm
Figure 24: Cancer Incidence Forecast in the Seven Major Markets, 2008-2020
Figure 25: Cancer Pain Incidence Forecast in the Seven Major Markets, 2008-2020
Figure 26: WHO’s Three-Step ‘Analgesia Ladder’ for Cancer Pain Management
Figure 27: Low Back Pain Incidence Forecast in the Seven Major Markets, 2008-2020
Figure 28: Back Pain Treatment Algorithm
Figure 29: LidoPAIN BP’s Phase IIa Back Pain Trial Results
Figure 30: Schematic Diagram of Blood Oxygenation Level Dependent (BOLD) Concept in MRI
Figure 31: SWOT Analysis of the Pain Therapeutics Market, 2010
Figure 32: Worldwide Leading Branded Pain Therapeutic Revenue Forecast ($m), 2004-2015
Figure 33: Financial Forecast of the NSAID Global Market ($m), 2009-2015
Figure 34: Financial Forecast of the COX-2 Global Market ($m), 2009-2015
Figure 35: Financial Forecast of the Opioid Global Market ($m), 2009-2015
Figure 36: Financial Forecast of the Triptan Global Market ($m), 2009-2015
Figure 37: Financial Forecast of the Nontraditional/Adjuvant Global Market ($m), 2009-2015
Figure 38: Financial Forecast of Local Anesthetics Global Market ($m), 2009-2015
Figure 39: Total Global Pain Therapeutics Market Forecast ($m) by Drug Class, 2009-2015
Figure 40: Total Global Pain Therapeutics Market Revenue Forecast ($m), 2009-2015
