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.

QUESTIONS ANSWERED

  • 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?

PRODUCT DESCRIPTION

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

  • Postoperative Pain - Unmet Need - 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
        • Products for Postoperative Pain
    • Treatment Drivers and Goals
      • Key Findings: Attribute Importance
      • Relative Importance of Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Surveyed Anesthesiologists' Prescribing Decisions in Postoperative Pain
      • Importance of Efficacy Attributes to Prescribing Decisions in Postoperative Pain: United States
      • Importance of Efficacy Attributes to Prescribing Decisions in Postoperative Pain: Europe
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Postoperative Pain: United States
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Postoperative Pain: Europe
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in Postoperative Pain: United States
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in Postoperative Pain: Europe
      • Importance of Nonclinical Factors to Prescribing Decisions in Postoperative Pain: United States
      • Importance of Nonclinical Factors to Prescribing Decisions in Postoperative Pain: Europe
      • Key Findings: Stated vs. Derived Importance
      • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Postoperative Pain: United States
      • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Postoperative Pain: Europe
    • Product Performance Against Treatment Drivers and Goals
      • Key Findings
      • Overall Performance of Key Therapies for Postoperative Pain: United States
      • Overall Performance of Key Therapies for Postoperative Pain: Europe
      • Relative Performance of Key Therapies for Postoperative Pain Across Select Efficacy Attributes: United States
      • Relative Performance of Key Therapies for Postoperative Pain Across Select Efficacy Attributes: Europe
      • Relative Performance of Key Therapies for Postoperative Pain Across Select Safety and Tolerability Attributes: United States
      • Relative Performance of Key Therapies for Postoperative Pain Across Select Safety and Tolerability Attributes: Europe
      • Relative Performance of Key Therapies for Postoperative Pain Across Select Convenience of Administration Attributes: United States
      • Relative Performance of Key Therapies for Postoperative Pain Across Select Convenience of Administration Attributes: Europe
      • Relative Performance of Key Therapies for Postoperative Pain Across Select Nonclinical Attributes: United States
      • Relative Performance of Key Therapies for Postoperative Pain Across Select Nonclinical Attributes: Europe
    • Assessment of Unmet Need
      • Key Findings: Unmet Need in Postoperative Pain
      • Surveyed Anesthesiologists’ Satisfaction with the Performance of Key Therapies for Postoperative Pain on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
      • Surveyed Anesthesiologists’ Satisfaction with the Performance of Key Therapies for Postoperative Pain on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
      • Surveyed Anesthesiologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Postoperative Pain: United States
      • Surveyed Anesthesiologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Postoperative Pain: Europe
      • Surveyed Anesthesiologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Postoperative Pain: United States
      • Surveyed Anesthesiologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Postoperative Pain: Europe
      • Surveyed Anesthesiologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Postoperative Pain: United States
      • Surveyed Anesthesiologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Postoperative Pain: Europe
      • Surveyed Anesthesiologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in Postoperative Pain: United States
      • Surveyed Anesthesiologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in Postoperative Pain: Europe
      • Key Findings: Unmet Need in Postoperative Pain and Related Indications
      • Surveyed Anesthesiologists' Ascribed Level of Unmet Need in Postoperative Pain and Related Indications: United States
      • Surveyed Anesthesiologists' Ascribed Level of Unmet Need in Postoperative Pain and Related Indications: Europe
    • 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
        • Attributes and Attribute Levels
      • Attribute Importance and Part-Worth Utilities
        • Postoperative Pain Target Product Profile: Attribute Importance
        • Efficacy For Providing Postoperative Pain Relief
        • Efficacy in Reducing Postoperative Opioid Consumption over 24 Hours vs. Placebo
        • Incidence of at Least One Treatment-Emergent Adverse Event
        • Incidence of at Least One Treatment-Emergent Serious Adverse Event
        • Onset of Action
        • Duration of Effect
        • Price/Dose Relative to Branded Acetaminophen/Paracetamol IV
      • Conjoint Analysis-Based Simulations of Market Scenarios
        • Postoperative Pain Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 1
        • Postoperative Pain Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 1
        • Postoperative Pain Market Simulations: Target Product Profiles Included in Scenario 1
        • Postoperative Pain Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 2
        • Postoperative Pain Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 2
        • Postoperative Pain Market Simulations: Target Product Profiles Included in Scenario 2
    • Appendix
      • Key Abbreviations
      • Experts Interviewed
      • Bibliography

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

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.

Emma McFadden, Ph.D., 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 epilepsy. 

Prior to joining Decision Resources Group, Emma earned a B.A. in neuroscience and a Ph.D. in biochemistry from Trinity College Dublin.

 


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