Abuse-deterrent formulations (ADFs) of opioid analgesics entered the U.S. pain market in 2010 as an attempt to slow the increasing rates of abuse/misuse and diversion stemming from chronic use of opioid analgesics. These relatively costly branded analgesics have struggled to garner notable patient share in the crowded and highly generic pain market owing to questions regarding their efficacy in deterring abuse and their cost-effectiveness. Public pressure and state legislation have promoted more-favorable coverage of certain ADF agents on private and public health insurance in recent years, but unfavorable market access and reimbursement of ADFs, as a class, continue to constrain prescribing to a small subset of the sizable number of chronic pain patients depending on opioid analgesics.


  • How do surveyed payers reimburse the six available ADFs of opioid analgesics? What restrictions do they impose on these agents? How do market access dynamics influence physician prescribing of ADFs of opioid analgesics for chronic pain patients?
  • How will emerging therapies with human abuse potential trial data be reimbursed? How do surveyed physicians expect to prescribe branded therapies with lower drug likeability?
  • What actions can marketers of analgesics for chronic pain employ to succeed in terms of market access and therefore overall sales?

Geography: United States

Primary Research: Survey of 101 U.S. pain specialists. Survey of 30 U.S. managed care organization (MCO) pharmacy and medical directors (PDs/MDs)

Key Drugs Covered: OxyContin, Xtampza ER, Hysingla ER, Embeda, MorphaBond, RoxyBond

Content Highlights: Reimbursement and contracting; access and prescribing; special topics; opportunities and challenges for emerging therapies


U.S. Access & Reimbursement provides in-depth insight on the impact of payer policy on prescribing behavior so that clients can build their market access strategy and optimize their brand positioning. This analysis of primary market research with physician specialists and U.S. payers helps clients stay up-to-date on restriction policies, gauge payer and prescriber attitudes toward specific therapies, identify opportunities where brands can capture patient share through market access, and maximize opportunities for emerging therapies by learning how previous brands gained favorable reimbursement or why they stumbled.

Table of contents

  • Chronic Pain - Access & Reimbursement - Detailed, Expanded Analysis: Abuse-Deterrent Opioid Analgesics In Chronic Pain
    • Access & Reimbursement - Chronic Pain - Abuse-Deterrent Opioid Analgesics - US - April 2019

Author(s): Joyce Spadafora, ALM

Joyce is a business insights analyst in Decision Resources Group’s central nervous systems and ophthalmology division, where she provides expert insight into commercial aspects of drug development and market sizing across psychiatric and pain indications. She has worked extensively in DRG’s schizophrenia and chronic pain content.

Prior to joining DRG, Joyce spent several years in the biotech industry focused in research and development and in biotech consulting. Her project experience covered indications including psychiatry, pain, infectious diseases, respiratory, and ophthalmology. Beyond my therapeutic and industry knowledge, she holds a Masters in Extension Studies in Psychology from Harvard University and a B.S in Mechanical Engineering with Biology from the Massachusetts Institute of Technology.

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