Chronic low back pain (CLBP), defined as continuous low back pain lasting for at least three months, represents the largest segment of the chronic pain therapy market. Prescription treatment options include nonsteroidal anti-inflammatory drugs (NSAIDs), opioid-based analgesics, antiepileptic drugs, and cytokine inhibitors. Although prescription drug-treatment rates in this population are relatively high, opportunity exists for more-potent yet safe therapies. This content provides quantitative insight into U.S. and European primary care physicians’ perceptions of the key treatment drivers and goals in the management of CLBP, the existing level of unmet need in this indication, and the remaining commercial opportunities.

QUESTIONS ANSWERED

  • What are the treatment drivers and goals for CLBP?
  • What drug attributes are key influencers, which have limited impact, and which are hidden opportunities?
  • How do current therapies such as tramadol ER (Janssen’s Ultram ER, Grünenthal’s Contramal, other brands, generics) and Duexis (Horizon Therapeutics’ ibuprofen / famotidine; in the United States) perform on key treatment drivers and goals for CLBP?
  • What are the top areas of unmet need and opportunity in CLBP?
  • What trade-offs in drug price and drug performance across key drug attributes are surveyed U.S. PCPs and European GPs willing to make?

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, France, Germany, United Kingdom

Primary research: Survey of 60 U.S. PCPs and 31 European GPs fielded in January 2020.

Key companies: Bristol-Myers Squibb, Horizon Therapeutics, Janssen, Pfizer, Purdue

Key drugs: Celecoxib, Duexis (ibuprofen / famotidine), fentanyl transdermal patch, oxycodone CR, pregabalin, tramadol ER, triamcinolone (injectable)

Table of contents

  • Chronic Pain - Unmet Need - Detailed, Expanded Analysis - Chronic Low Back Pain (US/EU)
    • Executive Summary
      • Unmet Need - Chronic Low Back Pain - Executive Summary - March 2020
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Rationale for Drug Selection
          • Products for CLBP and Rationale for Drug Selection
      • Treatment Drivers and Goals
        • Key Findings: Attribute Importance
        • Relative Importance of Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Surveyed PCPs'/GPs' Prescribing Decisions in CLBP
        • Importance of Efficacy Attributes to Prescribing Decisions in CLBP: United States
        • Importance of Efficacy Attributes to Prescribing Decisions in CLBP: Europe
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in CLBP: United States
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in CLBP: Europe
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in CLBP: United States
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in CLBP: Europe
        • Importance of Nonclinical Factors to Prescribing Decisions in CLBP: United States
        • Importance of Nonclinical Factors to Prescribing Decisions in CLBP: 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 CLBP: United States
        • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in CLBP: Europe
      • Product Performance Against Treatment Drivers and Goals
        • Key Findings
        • Overall Performance of Key Therapies for CLBP: United States
        • Overall Performance of Key Therapies for CLBP: Europe
        • Mean Overall Performance of Key Therapies for CLBP: United States and Europe
        • Relative Performance of Key Therapies for CLBP Across Select Efficacy Attributes: United States
        • Relative Performance of Key Therapies for CLBP Across Select Efficacy Attributes: Europe
        • Relative Performance of Key Therapies for CLBP Across Select Safety and Tolerability Attributes: United States
        • Relative Performance of Key Therapies for CLBP Across Select Safety and Tolerability Attributes: Europe
        • Relative Performance of Key Therapies for CLBP Across Select Convenience of Administration Attributes: United States
        • Relative Performance of Key Therapies for CLBP Across Select Convenience of Administration Attributes: Europe
        • Relative Performance of Key Therapies for CLBP Across Select Nonclinical Attributes: United States
        • Relative Performance of Key Therapies for CLBP Across Select Nonclinical Attributes: Europe
      • Assessment of Unmet Need
        • Key Findings: Unmet Need in CLBP
        • Surveyed PCPs’ Satisfaction with the Performance of Key Therapies for CLBP on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
        • Surveyed GPs’ Satisfaction with the Performance of Key Therapies for CLBP on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
        • Surveyed PCPs' Ascribed Level of Unmet Need Across Key Efficacy Attributes in CLBP: United States
        • Surveyed GPs' Ascribed Level of Unmet Need Across Key Efficacy Attributes in CLBP: Europe
        • Surveyed PCPs' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in CLBP: United States
        • Surveyed GPs' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in CLBP: Europe
        • Surveyed PCPs' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in CLBP: United States
        • Surveyed GPs' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in CLBP: Europe
        • Surveyed PCPs' Ascribed Level of Unmet Need Across Key Nonclinical Factors in CLBP: United States
        • Surveyed GPs' Ascribed Level of Unmet Need Across Key Nonclinical Factors in CLBP: Europe
        • Key Findings: Unmet Need in CLBP and Related Indications
        • Surveyed PCPs' Ascribed Level of Unmet Need in CLBP and Related Indications: United States
        • Surveyed GPs' Ascribed Level of Unmet Need in CLBP and Related Indications: Europe
      • Opportunity Analysis
        • Areas of Opportunity in the CLBP Market and Emerging Therapy Insights
          • Opportunity: A New Oral Therapy with Better Efficacy and Less-Severe Side Effects
          • Opportunity: A New Agent with Fewer / No Controlled Substance Restrictions
      • Target Product Profiles
        • Assessing Drug Development Opportunities
        • Target Product Profile Methodology
          • Attributes and Attribute Levels
        • Attribute Importance and Part-Worth Utilities
          • CLBP Target Product Profile: Attribute Importance
          • Mean Point Reduction from Baseline in Pain Intensity: NRS Score
          • Mean Point Reduction from Baseline in RMDQ Total Score
          • Controlled Substance Restrictions Imposed on Manufacture / Distribution / Prescription
          • % of Patients Experiencing GI Side Effects vs. Placebo
          • % of Patients Experiencing CNS-mediated Side Effects vs. Placebo
          • Delivery Profile
          • Price per Treated Day
        • Conjoint Analysis-Based Simulation of a Market Scenario
          • CLBP Market Simulation: Share of Preference of Target Product Profiles Included in the Market Scenario
          • CLBP Market Simulation: Likelihood to Prescribe Target Product Profiles Included in the Market Scenario
          • CLBP Market Simulation: Target Product Profiles Included in the Market Scenario
      • Appendix
        • Key Abbreviations

    Author(s): Bethany A. Kiernan, PhD

    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.


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