Cancer pain is a complex form of chronic pain to treat because it typically involves mixed nociceptive and neuropathic pain resulting from multiple causes (e.g., chemotherapy, metastases). Treatment decisions are further complicated by differing patient responses to analgesics, intrusive side effects, and safety / tolerability issues that are pervasive among the many analgesic drug classes (e.g., opioid analgesics, antiepileptic drugs) prescribed for cancer pain. Currently, traditional opioid analgesics, most of which are generically available, dominate the treatment of cancer pain. With the exception of costly abuse-deterrent reformulations of certain opioid analgesics, no truly novel or mechanism-based therapies have launched in recent years. As cancer survival rates continue to grow and life expectancy increases, so too do the prevalence of cancer pain and the need for more analgesic treatments that are tolerable over the long term.


  • How is cancer pain being treated in the United States today, and what are the drivers and constraints influencing physicians’ treatment decisions?
  • How do opioid analgesics with less abuse potential and therapies effective in treating neuropathic pain fit into the treatment algorithm for cancer pain?
  • What factors drive switching between or discontinuation of select analgesics?
  • How do physicians characterize recent changes in their treatment of cancer pain, and what changes to current usage do they expect within the next year?

GEOGRAPHY: United States

PRIMARY RESEARCH: Survey of 50 U.S. oncologists and 50 U.S. pain specialists

KEY DRUGS COVERED: Fentanyl transdermal patch (Duragesic, generics), Nucynta IR / ER (tapentadol IR / ER), oxycodone CR / ER (OxyContin, generics; Xtampza ER), pregabalin (Lyrica, generics)


  • Factors influencing disease management and treatment decisions.
  • Drivers and constraints of treatment selection.
  • Physician-reported treatment practices and brand-level patient shares.
  • Rationale for changes in treatment approach.
  • Physician insight on persistency and compliance.
  • Physician-reported recent/anticipated changes in brand usage or treatment approach.


Current Treatment: Physician Insights provides physician insights on treatment dynamics, prescribing behavior, and drivers of brand use so that marketers can create specific messaging around these treatment dynamics to more effectively increase or defend their market position.

Table of contents

  • Cancer Pain - Current Treatment - Detailed, Expanded Analysis (US)
    • Current Treatment Physician Insights - Cancer Pain - US - September 2020

Author(s): Bethany A. Kiernan, PhD; Joyce Spadafora, ALM

Bethany A. Kiernan, Ph.D., is a senior director in the central nervous system/ophthalmology disorders unit of Decision Resources Group. While at Decision Resources Group, Dr. Kiernan has covered the market dynamics of numerous indications, including schizophrenia, depression, migraine, multiple sclerosis, epilepsy, and other disorders.

Dr. Kiernan’s previous experience includes eight years of scientific research conducted at Tufts University School of Medicine, Case Western Reserve University, and the College of the Holy Cross. Dr. Kiernan earned her Ph.D. degree from Case Western Reserve University.

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.