The treatment of neuropathic pain involves the use of drugs from several drug classes, including antidepressants, antiepileptic drugs, local anesthetics, dual-acting opioid analgesics, and opioid analgesics. Despite the increasing availability of generic analgesics from these drug classes, as well as the continued entrenchment of select therapies as key treatment options for neuropathic pain, unmet need for new analgesics—particularly those with novel mechanisms of action—remains, driven by the growing prevalence of the neuropathic pain patient population and the sizable percentage of patients refractory to current treatment.

Questions Answered:

  • What is the current state of treatment for neuropathic pain? What are interviewed experts’ opinions of current treatment options?
  • What are interviewed experts’ views on late-phase emerging therapies such as Pfizer / Eli Lilly’s tanezumab, Regeneron / Teva / Mitsubishi Tanabe Pharma’s fasinumab, Grünenthal’s cebranopadol, and Daiichi Sankyo’s mirogabalin as potential treatments for neuropathic pain?
  • What is the commercial potential of late-phase analgesic products in the neuropathic pain market should they launch?
  • How will the neuropathic pain therapy market evolve over the next decade in light of expanding generic competition and the entrance of new treatments through 2028?

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.

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

Primary research: Approximately 20 country-specific interviews with thought-leading neuropathic pain experts, pain specialists, and neurologists. Supported by survey data collected for other DRG research.

Epidemiology: Prevalence of neuropathic back pain, painful diabetic neuropathy, neuropathic cancer pain, and HIV/AIDS-related neuropathic pain by country; diagnosed prevalence of postherpetic neuralgia by country.

Forecast:Ten-year, top-down sales of key neuropathic pain therapies through 2028. Market segmentation of select neuropathic pain populations in the forecast base year (2018).

Emerging therapies: Phase III/PR: 5 drugs; Phase II: 15 drugs.

Table of contents

  • Neuropathic Pain - Landscape & Forecast - Disease Landscape & Forecast
    • Key Findings
      • Neuropathic Pain – Key Findings – June 2020
    • Key Updates
      • June 2020
      • December 2019
      • September 2019
      • June 2019
      • March 2019
    • Market Outlook
      • Key Findings
        • Market Share of Neuropathic Pain by Indication, 2018
        • Market Share of Drug Classes for Neuropathic Pain: 2018
        • Market Share of Drug Classes for Neuropathic Pain: 2028
        • Neuropathic Pain SWOT Analysis
      • COVID-19: Areas of Potential Forecast Impact
        • Market Drivers and Constraints
          • What Factors Are Driving the Market for Neuropathic Pain?
          • What Factors Are Constraining the Market for Neuropathic Pain?
          • Neuropathic Pain Market Sales, by Region, 2018, 2023, and 2028
        • Drug-Class-Specific Trends
          • Major-Market Sales of Antiepileptic Drugs for Neuropathic Pain, 2018, 2023, and 2028
          • Major-Market Sales of Antidepressants for Neuropathic Pain, by Molecule, 2018, 2023, and 2028
          • Major-Market Sales of the 5% Lidocaine Patch for Neuropathic Pain, 2018, 2023, and 2028
          • Major-Market Sales of Anti-NGF Therapies for Neuropathic Pain by Region, 2023 and 2028
          • Major-Market Sales of Dual-Acting Opioid Analgesics for Neuropathic Pain, by Molecule, 2018, 2023, and 2028
          • Major-Market Sales of Opioid Analgesics for Neuropathic Pain, by Region, 2018, 2023, and 2028
          • Major-Market Sales of Emerging Therapies for Neuropathic Pain, 2023 and 2028
          • Total Sales of Emerging Therapies for Neuropathic Pain by Region, 2023 and 2028
      • Forecast
        • Sales of Drugs to Treat Neuropathic Pain in the Major Pharmaceutical Markets, by Indication, 2018
        • Drug Class Sales to Treat "Other" Neuropathic Pain Indications in the Major Pharmaceutical Markets, 2018
        • Sales of Drugs to Treat Neuropathic Pain in the Major Pharmaceutical Markets, 2018, 2023, and 2028
      • Etiology and Pathophysiology
        • Disease Overview
          • Etiology of Select Neuropathic Pain Disorders
            • Diabetic Neuropathy
            • Postherpetic Neuralgia
            • HIV / AIDS-Related Neuropathic Pain
            • Neuropathic Cancer Pain
            • Neuropathic Back Pain
            • Complex Regional Pain Syndrome
            • Central Neuropathic Pain
          • Pathophysiology of Neuropathic Pain
            • Overview
            • Peripheral Sensitization
            • Central Sensitization
            • Immune and Glial Cell Activation
            • Genetic Factors
          • Clinical Presentation of Neuropathic Pain
            • Key Pathways and Drug Targets
              • Ascending and Descending Pain Pathways
              • Drug Targets in Neuropathic Pain
              • Detailed Schematic of the Nociceptive and Antinociceptive Molecular Pathway in the Dorsal Horn
          • Epidemiology
            • Key Findings
              • Epidemiology Populations
                • Number of Prevalent Cases of Neuropathic Pain Indications of Interest in the Major Pharmaceutical Markets (in thousands): 2018 - 2028
                • Disease Definition
                • Methods
                • Sources Used for Total Prevalent Cases of HIV / AIDS-Related Neuropathic Pain
                • Number of Total Prevalent Cases of HIV/AIDS-Related Neuropathic Pain in the Major Pharmaceutical Markets (in thousands): 2018-2028
                • Disease Definition
                • Methods
                • Sources Used for Total Prevalent Cases of Neuropathic Back Pain
                • Number of Total Prevalent Cases of Neuropathic Back Pain in the Major Pharmaceutical Markets (in thousands): 2018-2028
                • Disease Definition
                • Methods
                • Sources Used for Total Prevalent Cases of Neuropathic Cancer Pain
                • Number of Total Prevalent Cases of Neuropathic Cancer Pain in the Major Pharmaceutical Markets (in thousands): 2018-2028
                • Disease Definition
                • Methods
                • Sources Used for Total Prevalent Cases of Painful Diabetic Neuropathy
                • Number of Total Prevalent Cases of Painful Diabetic Neuropathy in the Major Pharmaceutical Markets (in thousands): 2018-2028
                • Disease Definition
                • Methods
                • Sources Used for Diagnosed Prevalent Cases of Postherpetic Neuralgia
                • Number of Diagnosed Prevalent Cases of Postherpetic Neuralgia in the Major Pharmaceutical Markets (in thousands): 2018-2028
                • Trigeminal Neuralgia
                • Central Neuropathic Pain
                • Postoperative Neuropathic Pain
                • Carpal Tunnel Syndrome
                • Complex Regional Pain Syndrome
                • Percentage Diagnosed
                • Percentage Drug-Treated
                • Percentage of Individuals Diagnosed and Drug-Treated in Key Neuropathic Pain Populations, 2018, 2023, and 2028
            • Current Treatment
              • Key Findings
                • Treatment Goals
                  • Key Endpoints Used in Clinical Trials for Neuropathic Pain
                • Key Current Therapies
                  • Overview
                  • Mechanism of Action of Key Current Drug Classes Used for Neuropathic Pain
                  • Current Treatments Used for Neuropathic Pain
                  • Market Events Impacting the Use of Key Current Therapies in Neuropathic Pain
                  • Advantages and Disadvantages of Gabapentin
                  • Expert Insight: Gabapentin
                  • Advantages and Disadvantages of Pregabalin
                  • Expert Insight: Pregabalin
                  • Advantages and Disadvantages of Pregabalin CR
                  • Expert Insight: Pregabalin CR
                  • Advantages and Disadvantages of Gralise
                  • Expert Insight: Gralise
                  • Advantages and Disadvantages of Horizant
                  • Expert Insight: Horizant
                  • A Note on Gabapentinoids
                  • Advantages and Disadvantages of Tarlige
                  • Ongoing Clinical Development of Tarlige
                  • Key Ongoing Clinical Trials of Tarlige in the Treatment of Neuropathic Pain
                  • Expert Insight: Tarlige
                  • Advantages and Disadvantages of Carbamazepine
                  • Advantages and Disadvantages of Duloxetine
                  • Expert Insight: Duloxetine
                  • Advantages and Disadvantages of Tricyclic Antidepressants
                  • Expert Insight: Tricyclic Antidepressants
                  • Advantages and Disadvantages of Other Antidepressants
                  • Advantages and Disadvantages of the 5% Lidocaine Patch
                  • Expert Insight: 5% Lidocaine Patch
                  • Advantages and Disadvantages of Qutenza
                  • Expert Insight: Qutenza
                  • Advantages and Disadvantages of Tramadol ER
                  • Expert Insight: Tramadol
                  • Advantages and Disadvantages of Tapentadol ER
                  • Expert Insight: Tapentadol
                  • Advantages and Disadvantages of Opioid Analgesics
                  • Expert Insight: Opioid Analgesics
                  • Nonpharmacological Treatment
                • Medical Practice
                  • Overview
                  • Regional Neuropathic Pain Treatment Guidelines
                  • Factors Influencing Drug Selection in Neuropathic Pain
                  • Treatment Decision Tree for Neuropathic Pain: United States
                  • Treatment Decision Tree for Neuropathic Pain: Europe
                  • Treatment Decision Tree for Neuropathic Pain: Japan
              • Unmet Need Overview
                • Current and Future Attainment of Unmet Needs in Neuropathic Pain
                • Top Unmet Needs in Neuropathic Pain: Current and Future Attainment
              • Emerging Therapies
                • Key Findings
                  • Pipeline Trends for Neuropathic Pain
                • Key Emerging Therapies
                  • Key Therapies in Development for Neuropathic Pain
                  • Estimated Launch Dates of Key Emerging Therapies for the Treatment of Neuropathic Pain
                  • BIIB074 Profile
                  • Analysis of the Clinical Development Program for BIIB074
                  • Clinical Development Milestones for BIIB074 in the Treatment of Neuropathic Pain
                  • Expert Insight: BIIB074
                  • Expectations for Launch and Sales Opportunity of BIIB074 in Neuropathic Pain
                  • Likely Uses of BIIB074 for the Treatment of Neuropathic Pain
                  • AmiKet / AmiKet Nano Profile
                  • Analysis of the Clinical Development Program for AmiKet / AmiKet Nano
                  • Expert Insight: AmiKet / AmiKet Nano
                  • Expectations for Launch and Sales Opportunity of AmiKet / AmiKet Nano in Neuropathic Pain
                  • Fasinumab Profile
                  • Analysis of the Clinical Development Program for Fasinumab
                  • Key Development Milestones for Fasinumab in the Treatment of Neuropathic Pain
                  • Expert Insight: Fasinumab
                  • Expectations for Launch and Sales Opportunity of Fasinumab in Neuropathic Pain
                  • Tanezumab Profile
                  • Analysis of the Clinical Development Program for Tanezumab
                  • Key Development Milestones for Tanezumab in the Treatment of Neuropathic Pain
                  • Expert Insight: Tanezumab
                  • Expectations for Launch and Sales Opportunity of Tanezumab in Neuropathic Pain
                  • Likely Uses of Anti-NGF Therapies for the Treatment of Neuropathic Pain
                  • Cebranopadol Profile
                  • Analysis of the Clinical Development Program for Cebranopadol
                  • Clinical Development Milestones for Cebranopadol in the Treatment of Neuropathic Pain
                  • Expert Insight: Cebranopadol
                  • Expectations for Launch and Sales Opportunity of Cebranopadol in Neuropathic Pain
                  • Likely Uses of Cebranopadol for the Treatment of Neuropathic Pain
                  • Engensis / VM202 Profile
                  • Analysis of the Clinical Development Program for Engensis / VM202
                  • Expert Insight: Engensis / VM202
                  • Expectations for Launch and Sales Opportunity of Engensis / VM202 in Neuropathic Pain
                  • Neridronic Acid Profile
                  • Analysis of the Clinical Development Program for Neridronic Acid
                  • Clinical Development Milestones for Neridronic Acid in the Treatment of Neuropathic Pain
                  • Expert Insight: Neridronic Acid
                  • Expectations for Launch and Sales Opportunity of Neridronic Acid in Neuropathic Pain
                • Early-Phase Pipeline Analysis
                  • Select Phase I and Phase II Compounds in Development for Neuropathic Pain
                • Key Discontinuations and Failures in Neuropathic Pain
                • Access & Reimbursement Overview
                  • Region-Specific Reimbursement Practices
                    • Key Market Access Considerations in Neuropathic Pain: United States
                    • General Reimbursement Environment: United States
                    • Key Market Access Considerations in Neuropathic Pain: EU5
                    • General Reimbursement Environment: EU5
                    • Key Market Access Considerations in Neuropathic Pain: Japan
                    • General Reimbursement Environment: Japan
                  • Looking for More?
                • Methodology
                  • Appendix
                    • Key Abbreviations Related to Neuropathic Pain
                    • Brands, Marketers, and Generic Availability of Current Therapies Used for Neuropathic Pain by Market
                    • Neuropathic Pain Bibliography

                Author(s): Bethany A. Kiernan, PhD; Angela Sparrow, Ph.D.; Andrea Witt, PhD; Sunali D. Goonesekera, SM; Natalie Taylor, PhD; Audreza Das, P.G. Dip. ; Niyati Khetarpal, Ph.D; Shefali Gulati, MBA Pharm

                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.

                Angela Sparrow provides expert insight and authors primary market research and forecasting content as a member of the Central Nervous System and Ophthalmology Team. During her time with the company, Angela has extensively covered migraine, contributing to numerous reports while staying up-to-date on the latest trends and news. Additionally, she provides detailed responses to client inquiries and has authored content focused on psychiatric indications, including opioid addiction and depression, as well as neuropathic pain.

                Dr. Sparrow holds a Ph.D. in behavioral neuroscience from the University of North Carolina at Chapel Hill and a Bachelor’s degree from Northeastern University. Before joining DRG, she was a postdoctoral fellow at McLean Hospital, Harvard Medical School, studying the role of kappa opioid receptors in addiction and withdrawal-induced depression.

                Andrea S. Witt, Ph.D., is Therapy Leader of the Central Nervous System and Ophthalmology Disorders Portfolio at Decision Resources Group where she oversees a team of 14 Business Insights Analysts and Senior Directors responsible for market research encompassing Neurology, Psychiatry, Pain, and Ophthalmology.

                 Dr. Witt has been with Decision Resources Group for over 12 years, following CNS markets and trends. Her interests beyond specific CNS indications included the market potential for neuroprotectants and the impact of biomarkers on CNS markets. Dr. Witt’s research, analysis, and commentaries have appeared in Barron’s, Pharmaceutical Executive, PharmaVoice, Nature Medicine, and CNBC. Dr. Witt’s previous experience includes 10 years of scientific research conducted on neurodegenerative disorders at Harvard Medical School/Brigham and Women’s Hospital, Duke University, and the University of Texas-Southwestern Medical Center, where she earned her Ph.D. degree.

                Sunali Goonesekera is an Associate Epidemiologist at Decision Resources Group.

                Sunali holds a Master’s degree in Epidemiology from the Harvard School of Public Health and a B.A. in Biology (Honors) from Dartmouth College. Prior to joining Decision Resources Group, Sunali conducted epidemiological research and lead authored two manuscripts on racial/ethnic disparities in metabolic diseases at the New England Research Institutes. She has contributed to multiple publications in peer-reviewed journals in epidemiology and in the biological sciences.

                Natalie Taylor, Ph.D. 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 Ph.D. 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 B.S. in Biology from Dickinson College in Carlisle, Pennsylvania.

                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.

                "Niyati Khetarpal is a business insights analyst on the Central Nervous System, Pain, and Ophthalmology team at Decision Resources Group. In this role, she conducts primary and secondary research to analyze pharmaceutical markets, with a focus on neurology indications, including epilepsy and MS. She also has specific expertise in patent/IP research. Prior to joining the company, Niyati obtained her doctorate from the International Centre for Genetic Engineering and Biotechnology for her research on Dengue virus vaccines. She received the Fulbright-Nehru doctoral scholarship in 2014 for her research on Dengue and West Nile virus envelope proteins.”

                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.