OA pain is the second largest segment of the overall chronic pain market, affecting more than 90 million patients in the G7. The OA pain market represents a lucrative opportunity for drug developers given the persistent unmet need for more effective and safe therapies, particularly those with a novel and distinct mechanism of action that strongly correlates with the nature of this type of pain. OA pain is predominantly treated with cost-effective generic NSAIDs and opioid analgesics, although branded agents such as costly abuse-deterrent reformulations of opioid analgesics, new combinations of existing NSAIDs that attempt to mitigate side effects, and intra-articular injections are also frequently prescribed in later lines of therapy. Emerging therapies, such as biological drugs from Pfizer / Eli Lilly and Regeneron / Teva / Mitsubishi Tanabe Pharma targeting NGF, and the increasing number of patients diagnosed with OA pain due to lifestyle influences will be key drivers for growth through 2028.

Questions answered:

  • How do interviewed experts perceive the OA pain marketplace to be changing given the emphasis on the risk of abuse / misuse with opioid analgesics?
  • What effect will the recent launches of new analgesics such as Flexion Therapeutics' Zilretta and Iroko’s Vivlodex continue to have on the treatment paradigm?
  • What will the impact of a new drug class, the anti-NGF biologics, be on the treatment landscape given their demonstrably robust efficacy tempered by lingering concerns about safety issues seen in clinical trials?

Markets covered: United States, France, Germany, Italy, Spain, United Kingdom, Japan.

Primary research: Thirteen country-specific interviews with thought-leading pain specialists and rheumatologists, supported by survey data collected for this and other DRG research.

Epidemiology: Diagnosed prevalence and drug-treated rates of OA pain by country.

Emerging therapies: Phase III / preregistration / registration: 8 drugs; Phase II: 7 drugs; coverage of select Phase I products.

Market forecast features: 10-year, annualized, drug-level sales and patient share of key analgesics through 2028, segmented by brands / generics.

Key companies: Acorda Therapeutics, Ampio Pharmaceuticals, Astellas, Centrexion, Collegium Pharmaceutical, Eli Lilly, Flexion Therapeutics, Iroko Pharmaceuticals, Mitsubishi Tanabe Pharma, Nektar Therapeutics, Pfizer, Purdue Pharma, Regeneron, Samumed, Teva.

Key drugs: acetaminophen / hydrocodone, Ampion, cebranopadol, celecoxib, CNTX-4975, fasinumab, Hysingla ER (hydrocodone ER), lorecivivint, Nucynta IR / ER (tapentadol IR / ER), oxycodegol (NKTR-181), oxycodone CR (OxyContin, generics), oxycodone ER (Xtampza ER), Qutenza (8% capsaicin patch), tanezumab, tramadol, Vivlodex (meloxicam, low dose), Zilretta (triamcinolone ER, injectable).

Product Description: Disease Landscape & Forecast provides comprehensive market intelligence with world-class epidemiology, keen insight into current treatment paradigms, in-depth pipeline assessments, and drug forecasts supported by detailed primary and secondary research.

Table of contents

  • Osteoarthritic Pain - Landscape & Forecast - Disease Landscape & Forecast
    • Key Findings
      • Osteoarthritic Pain – Key Findings – May 2020
    • Key Updates
      • May 2020
        • November 2019
          • September 2019
            • June 2019
              • January 2019
              • Market Outlook
                • Key Findings
                  • A Note on Emerging Therapies
                  • Market Share of Osteoarthritic Pain Drug Classes: 2018
                  • Market Share of Osteoarthritic Pain Drug Classes: 2028
                  • Osteoarthritic Pain SWOT Analysis
                • COVID-19: Areas of Potential Forecast Impact
                  • Market Drivers and Constraints
                    • What Factors Are Driving the Market for Osteoarthritic Pain?
                    • What Factors Are Constraining the Market for Osteoarthritic Pain?
                    • Major-Market Sales of Select Drug Classes in Osteoarthritic Pain: 2018-2028
                    • Major-Market Patient Share of Select Drug Classes in Osteoarthritic Pain: 2018-2028
                  • Drug-Class-Specific Trends
                    • Major-Market Sales of COX-2-Selective NSAIDs: 2018-2028
                    • Major-Market Patient Share of COX-2-Selective NSAIDs: 2018-2028
                    • Major-Market Sales of Select Cytokine Inhibitors: 2018-2028
                    • Major-Market Patient Share of Select Cytokine Inhibitors: 2018-2028
                    • Major-Market Sales of Dual-Acting Opioid Analgesics: 2018-2028
                    • Major-Market Patient Share of Dual-Acting Opioid Analgesics: 2018-2028
                    • Major-Market Sales of Local Anesthetics: 2018-2028
                    • Major-Market Patient Share of Local Anesthetics: 2018-2028
                    • Major-Market Sales of Key Prescription NSAIDs: 2018-2028
                    • Major-Market Patient Share of Key Prescription NSAIDs: 2018-2028
                    • Major-Market Sales of Key Opioid Analgesics: 2018-2028
                    • Major-Market Patient Share of Key Opioid Analgesics: 2018-2028
                    • Major-Market Sales of Opioid / Acetaminophen Combinations: 2018-2028
                    • Major-Market Patient Share of Opioid / Acetaminophen Combinations: 2018-2028
                    • Major-Market Sales of Select Viscosupplements: 2018-2028
                    • Major-Market Patient Share of Viscosupplements: 2018-2028
                    • Major-Market Sales of Anti-NGF Therapies: 2018-2028
                    • Major-Market Patient Share of Anti-NGF Therapies: 2018-2028
                    • Major-Market Sales and Patient Share of Wnt Pathway Inhibitors: 2018-2028
                • Forecast
                  • Market Forecast Downloads
                  • Market Forecast Assumptions - Osteoarthritic Pain (2018-2028) - May 2020
                  • Market Forecast Dashboard - Osteoarthritic Pain (2018-2028) - May 2020
                • Etiology and Pathophysiology
                  • Disease Overview
                    • Pathophysiology of OA
                      • Risk Factors Associated with the Development of Osteoarthritis
                      • Anatomy of the Healthy Synovial Joint: The Knee
                    • Normal Mechanisms of Pain Transmission
                      • Ascending and Descending Pathways in Osteoarthritic Pain
                      • Dorsal Root Ganglion Synapse
                    • Etiology of Osteoarthritis Pain
                      • Etiology of Osteoarthritic Pain: Inflammatory Pain
                      • Etiology of Osteoarthritic Pain: Peripheral and Central Sensitization
                      • Effect of NSAIDs on the Inflammatory Pathway
                    • Key Pathways and Drug Targets
                      • Select Drug Targets and Therapies in Development for Osteoarthritic Pain
                  • Epidemiology
                    • Key Findings
                      • Epidemiology Populations
                        • Disease Definition
                        • Methods
                        • Sources Used for Diagnosed Prevalent Cases of Osteoarthritic Pain
                        • Number of Diagnosed Prevalent Cases of Osteoarthritic Pain in the Major Pharmaceutical Markets: 2018-2028 (thousands)
                        • Drug-Treated Prevalent Cases of Osteoarthritic Pain: 2018-2028 (thousands)
                    • Current Treatment
                      • Key Findings
                        • Treatment Goals
                          • Key Endpoints Used in Clinical Trials for Osteoarthritic Pain
                        • Key Current Therapies
                          • Overview
                          • Mechanism of Action of Key Current Drug Classes Used for Osteoarthritic Pain
                          • Current Treatments Used for Osteoarthritic Pain
                          • Market Events Impacting the Use of Key Current Therapies for Osteoarthritic Pain
                          • Expert Insight: NSAIDs
                          • Advantages and Disadvantages of Ibuprofen
                          • Advantages and Disadvantages of Naproxen
                          • Advantages and Disadvantages of Oral / Topical Diclofenac
                          • Advantages and Disadvantages of Low-Dose Meloxicam
                          • Expert Insight: COX-2-Selective NSAIDs
                          • Advantages and Disadvantages of Celecoxib
                          • Advantages and Disadvantages of Etoricoxib
                          • Expert Insight: Opioid Analgesics
                          • Advantages and Disadvantages of Oxycodone
                          • Advantages and Disadvantages of Hydrocodone / Acetaminophen
                          • Expert Insight: Dual-Acting Opioid Analgesics
                          • Advantages and Disadvantages of Tramadol IR / ER
                          • Advantages and Disadvantages of Tapentadol IR / ER
                          • Expert Insight: Cytokine Inhibitors
                          • Advantages and Disadvantages of Triamcinolone ER
                          • Results from Select Clinical Trials Investigating Triamcinolone ER for the Treatment of Osteoarthritic Pain
                          • Key Ongoing Clinical Trials of Triamcinolone ER in the Treatment of Osteoarthritic Pain
                          • Expert Insight: Viscosupplements
                          • Advantages and Disadvantages of Synvisc / Synvisc-One
                          • Advantages and Disadvantages of Orthovisc
                        • Medical Practice
                          • Overview
                          • Regional Osteoarthritic Pain Treatment Guidelines
                          • Factors Influencing Drug Selection in Osteoarthritic Pain
                          • Treatment Decision Tree for Osteoarthritic Pain: United States
                          • Treatment Decision Tree for Osteoarthritic Pain: Europe
                          • Treatment Decision Tree for Osteoarthritic Pain: Japan
                      • Unmet Need Overview
                        • Current and Future Attainment of Unmet Needs in Osteoarthritic Pain
                        • Top Unmet Needs in Osteoarthritic Pain: Current and Future Attainment
                        • Expert Insight: Unmet Need in Osteoarthritic Pain
                      • Emerging Therapies
                        • Key Findings
                          • Pipeline Trends for Osteoarthritic Pain
                        • Key Emerging Therapies
                          • Key Emerging Therapies in Development for Osteoarthritic Pain
                          • Estimated Launch Dates of Key Emerging Therapies for the Treatment of Osteoarthritic Pain
                          • NSAIDs / COX-2-Selective NSAIDs in Development Likely to Be Prescribed for Osteoarthritic Pain
                          • Expert Insight: Emerging NSAID / COX-2-Selective NSAID Reformulations
                          • Expectations for Launch and Sales Opportunity of NSAID / COX-2-Selective NSAID Reformulations in Osteoarthritic Pain
                          • Ampion Profile
                          • Analysis of the Clinical Development Program for Ampion
                          • Expert Insight: Ampion
                          • Expectations for Launch and Sales Opportunity of Ampion in Osteoarthritic Pain
                          • CNTX-4975 Profile
                          • Analysis of the Clinical Development Program for CNTX-4975
                          • Expert Insight: CNTX-4975
                          • Expectations for Launch and Sales Opportunity of CNTX-4975 in Osteoarthritic Pain
                          • Oxycodegol (NKTR-181) Profile
                          • Analysis of Clinical Development Program for Oxycodegol (NKTR-181)
                          • Expert Insight: Oxycodegol (NKTR-181)
                          • Expectations for Launch and Sales Opportunity of Oxycodegol (NKTR-181) in Osteoarthritic Pain
                          • Cebranopadol Profile
                          • Analysis of the Clinical Development Program for Cebranopadol
                          • Expert Insight: Cebranopadol
                          • Expectations for Launch and Sales Opportunity of Cebranopadol in Osteoarthritic Pain
                          • Fasinumab Profile
                          • Key Ongoing Clinical Trials of Fasinumab in the Treatment of Osteoarthritic Pain
                          • Analysis of the Clinical Development Program for Fasinumab
                          • Expectations for Launch and Sales Opportunity of Fasinumab in Osteoarthritic Pain
                          • Key Results from Select Pivotal Clinical Trials Investigating Tanezumab for the Treatment of Osteoarthritic Pain
                          • Key Ongoing Clinical Trials of Tanezumab in the Treatment of Osteoarthritic Pain
                          • Analysis of the Clinical Development Program for Tanezumab
                          • Expectations for Launch and Sales Opportunity of Tanezumab in Osteoarthritic Pain
                          • Expert Insight: Anti-NGF Therapies
                          • Lorecivivint Profile
                          • Analysis of the Clinical Development Program for Lorecivivint
                          • Expert Insight: Lorecivivint
                          • Expectations for Launch and Sales Opportunity of Lorecivivint in Osteoarthritic Pain
                        • Early-Phase Pipeline Analysis
                          • Select Therapies in Early-Phase Development Likely to Be Prescribed for Osteoarthritic Pain
                          • Role of Disease-Modifying Therapies in Development for Osteoarthritis
                          • Disease-Modifying Therapies Being Investigated for Osteoarthritis
                      • Access & Reimbursement Overview
                        • Region-Specific Reimbursement Practices
                          • Key Market Access Considerations in Osteoarthritic Pain: United States
                          • General Reimbursement Environment: United States
                          • Key Market Access Considerations in Osteoarthritic Pain: EU5
                          • General Reimbursement Environment: EU5
                          • Key Market Access Considerations in Osteoarthritic Pain: Japan
                          • General Reimbursement Environment: Japan
                        • Looking for More?
                      • Methodology
                        • Bottom-Up Forecasting Overview
                          • Patient Populations
                          • Drug-Specific Assumptions
                        • Bottom-Up Forecast Assumptions
                          • General Sources of Data
                          • Agents Included in Our Market Analysis
                          • General Statements About Pricing
                          • Sources for Drug Prices
                          • 2018 Exchange Rates
                          • Dosing, Days of Therapy, and Compliance
                          • Generic Erosion
                          • Out-Year Forecasting
                          • Emerging Therapy Prices
                        • Primary Market Research
                          • Experts Interviewed
                      • Appendix
                        • Key Abbreviations Related to Osteoarthritic Pain
                        • Brands, Marketers, and Generic Availability of Key Therapies for Osteoarthritic Pain by Market
                        • Osteoarthritic Pain Bibliography

                    Author(s): Joyce Spadafora, ALM; Abey John, MPH; Bethany A. Kiernan, PhD; Audreza Das, P.G. Dip. ; Shefali Gulati, MBA Pharm

                    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.

                    Abey John is a medical graduate with a Master’s in Public Health and has been associated with DRG since September 2015. He works with a global team of epidemiologists in performing systematic reviews of assigned diseases and prepare forecast models for clients. He also is involved in producing analyses for pharmaceutical drug developers on the descriptive epidemiology of major drug indications in mature and developing markets and have an overall experience of three years working in different healthcare sectors across the country.

                    Prior to joining DRG, Abey had been working with Jhpiego (an affiliate of Johns Hopkins Medical University) in implementing Family Planning Health Programs in India with collaborating with the Government of India. He also has worked with a grassroots level NGO as a health team manager which worked for the benefit of the rural population living in the foothills of the Himalayas.

                    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.

                    Audreza Das is a Senior Analyst in the CNS/Ophthalmology team at Decision Resources Group

                    She has authored content across indications, including neuropathic pain, age-related macular degeneration, treatment-related depression, painful diabetic neuropathy, and migraine. Ms. Das has previously worked at Novo Nordisk, as a Market Analyst for European markets. Previous experience at a SME, included developing disease competitive landscapes, covering global conferences etc. Ms. Das received her B.E. degree in Biotechnology from Birla Institute of Technology, a deemed university and her P.G. Diploma in Cancer Immunology & Biotechnology from University of Nottingham.

                    Shefali Gulati, Associate analyst, is part of the Central Nervous System, Pain, and Ophthalmology team at Decision Resources Group.

                    She is responsible for performing extensive secondary market research and analysis for major pharmaceutical markets. She comes with one year of experience working on multiple client projects revolving around opportunity assessment, competitive landscape, pipeline analysis, and key product profiling. She holds a MBA degree in Pharmaceutical Management from the National Institute of Pharmaceutical Education and Research (NIPER) in India and Bachelor’s in Pharmacy from DIPSAR.