Market Outlook

As one of the larger segments in the overall market for acute pain therapies, the treatment of postoperative pain has experienced substantial growth over the past decade due to the market uptake of Mallinckrodt Pharmaceuticals’ Ofirmev and Pacira Pharmaceuticals’ Exparel in the United States. Nevertheless, unmet need remains for potent postoperative pain therapies that are not opioid analgesics and that can stave off persistent pain. Emerging therapies for moderate to severe postoperative pain will have to demonstrate convincing efficacy, safety, and convenience in multiple, well-designed clinical trials and have these advantages translate into clinical practice. Given generic analgesics’ low price, wide availability, and entrenched position in the first-line treatment of postoperative pain, market access will be challenging for emerging postoperative pain therapies unless a strong value proposition is made.


  • What are the treatment drivers and goals for moderate to severe postoperative pain?
  • What drug attributes are key influences, which have limited impact, and which are hidden opportunities?
  • How do current therapies perform on key treatment drivers and goals for moderate to severe postoperative pain?
  • What are the prevailing areas of unmet need and opportunity in moderate to severe postoperative pain?
  • What trade-offs across different clinical attributes and prices are acceptable to U.S. and European anesthesiologists for a hypothetical new moderate to severe postoperative pain drug?


Provides quantitative insight into U.S. and European physician perceptions of key treatment drivers and goals and the current level of unmet need for a specific disease. Commercial opportunities are analyzed, and the extent to which emerging therapies may capitalize on these opportunities is evaluated.

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

Primary research: Survey of 60 U.S. and 31 European anesthesiologists

Key companies: Mallinckrodt Pharmaceuticals, Pacira Pharmaceuticals, Trevena, Heron Therapeutics

Key drugs: Oral opioids, morphine IV, ketorolac IV/IM, Ofirmev, Perfalgan, tramadol, Exparel, bupivacaine, oliceridine, HTX-011

Key metrics included:

  • Stated versus derived analysis of U.S. and European physicians’ prescribing behavior.
  • Conjoint analysis with U.S. and European physicians, including market simulator.
  • Assessment of current drug performance against treatment drivers and goals.
  • Physician perceptions of unmet need in disease/subpopulation covered and related diseases/subpopulations.
  • Analysis of remaining drug development opportunities.

Table of contents

  • Detailed, Expanded Analysis: Post-operative Pain (US & EU)
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Efficacy
        • Safety and Tolerability
        • Convenience of Administration
        • Nonclinical Factors
      • Rationale for Drug Selection
    • Treatment Drivers and Goals
      • Key Findings: Attribute Importance
      • Key Findings: Stated vs. Derived Importance
    • Product Performance Against Treatment Drivers and Goals
      • Key Findings
    • Assessment of Unmet Need
      • Key Findings: Unmet Need in Postoperative Pain
      • Key Findings: Unmet Need in Postoperative Pain and Related Indications
    • Opportunity Analysis
      • Areas of Opportunity in the Postoperative Pain Market and Emerging Therapy Insights
        • Opportunity: A Therapy That Reduces Postoperative Opioid Consumption
        • Opportunity: A Therapy with Fewer Adverse Events than Opioid Analgesics
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
      • Attribute Importance and Part-Worth Utilities
        • Postoperative Pain Target Product Profile: Attribute-Level Part-Worth Utilities
      • Conjoint Analysis-Based Simulations of Market Scenarios
        • Scenario 1
        • Scenario 2
    • Appendix
      • Experts Interviewed
      • Bibliography

Author(s): Natalie Taylor, PhD; Emma McFadden, PhD

Natalie Taylor, is a Principal Business Insights Analyst with the central nervous system/ophthalmology disorders team at Decision Resources Group. She has over ten years of experience authoring primary and market research reports for pharmaceutical industry clients across multiple psychiatry, pain, neurology, and ophthalmology therapy areas. Prior to joining DRG, Dr. Taylor worked at QuintilesIMS as manager of the central nervous system portfolio of Disease Insights market forecasting offerings. She completed her in Physiology at Dartmouth College in Hanover, New Hampshire, where she studied the role of serotonergic neurons in the medullary raphe on modulating respiratory responses in mammals. She holds a in Biology from Dickinson College in Carlisle, Pennsylvania.

Emma McFadden, is a  Director within the Central Nervous System/Ophthalmology disorders group. Her main focus is on ophthalmic indications, such as age-related macular degeneration, diabetic retinopathy, and diabetic macular edema, although she has authored research across a number of other indications, including multiple sclerosis and ; Prior to joining Decision Resources Group, Emma earned a in neuroscience and a in biochemistry from Trinity College Dublin.  

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