The few currently available pharmacological treatments for opioid addiction fall into one of two categories: substitution therapies or abstinent therapies. Substitution therapies (i.e., methadone, buprenorphine, and buprenorphine / naloxone combination) prevent a patient from experiencing withdrawal symptoms but allow the patient to still experience a limited “high” without taking any illicit opioids. Abstinent therapies (i.e., naltrexone) block the euphoric effect of opioids if a patient attempts to take an illicit opioid. However, all of these drugs are associated with clinical shortcomings in efficacy, safety, and/or delivery, creating opportunities for new and improved alternatives. This report examines physicians’ key treatment drivers and analyzes the greatest areas of unmet treatment need and thereby the opportunities in this space.

Questions Answered

  • What are the treatment drivers and goals for opioid addiction?
  • Which drug attributes are key influencers, which have limited impact, and which are hidden opportunities?
  • How do buprenorphine-containing therapies (e.g., Suboxone Film, Sublocade) perform on key treatment drivers and goals for opioid addiction?
  • What are the prevailing areas of unmet need and opportunity in the treatment of opioid addiction?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European psychiatrists for a hypothetical new opioid addiction drug?

Markets covered: United States, United Kingdom, France, Germany

Primary research: Survey of 60 U.S. and 30 European psychiatrists fielded in November 2018

Key companies: Indivior, Orexo, Braeburn Pharmaceuticals, Camurus

Key drugs: Suboxone Film, Subutex, Sublocade, Zubsolv, methadone, naltrexone

Key metrics included:

  • Target Product Profile (TPP) simulator based on conjoint analysis methodology.
  • Stated versus derived importance of product attributes on prescribing behavior.
  • Assessment of current drug performance against treatment drivers and goals.
  • Physician perceptions of unmet needs in the indication and related indications.
  • Analysis of remaining drug development opportunities.

Product Description

Unmet Need supports clinical development decisions by identifying key attributes and assessing areas of unmet need for a specific disease or subpopulation. Based on surveys with U.S. and European physicians, this report provides insight into key treatment drivers and goals, the performance of current therapies, and the remaining commercial opportunities. Two market scenarios are profiled in detail by DRG experts, and additional customized market scenarios can be evaluated with the corresponding TPP simulator.

Table of contents

  • Opioid Addiction - Unmet Need - Detailed, Expanded Analysis (US/EU)
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Efficacy
        • Safety and Tolerability
        • Convenience of Administration
      • Rationale for Drug Selection
        • Products for Opioid Addiction
    • Treatment Drivers and Goals
      • Key Findings: Attribute Importance
      • Relative Importance of Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Surveyed Psychiatrists' Prescribing Decisions in Opioid Addiction
      • Importance of Efficacy Attributes to Prescribing Decisions in Opioid Addiction: United States
      • Importance of Efficacy Attributes to Prescribing Decisions in Opioid Addiction: Europe
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Opioid Addiction: United States
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Opioid Addiction: Europe
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in Opioid Addiction: United States
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in Opioid Addiction: 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 Opioid Addiction: United States
      • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Opioid Addiction: Europe
    • Product Performance Against Treatment Drivers and Goals
      • Key Findings
      • Overall Performance of Key Therapies for Opioid Addiction: United States
      • Overall Performance of Key Therapies for Opioid Addiction: Europe
      • Mean Overall Performance of Key Therapies for Opioid Addiction: United States and Europe
      • Relative Performance of Key Therapies for Opioid Addiction Across Select Efficacy Attributes: United States
      • Relative Performance of Key Therapies for Opioid Addiction Across Select Efficacy Attributes: Europe
      • Relative Performance of Key Therapies for Opioid Addiction Across Select Safety and Tolerability Attributes: United States
      • Relative Performance of Key Therapies for Opioid Addiction Across Select Safety and Tolerability Attributes: Europe
      • Relative Performance of Key Therapies for Opioid Addiction Across Select Convenience of Administration Attributes: United States
      • Relative Performance of Key Therapies for Opioid Addiction Across Select Convenience of Administration Attributes: Europe
    • Assessment of Unmet Need
      • Key Findings: Unmet Need in Opioid Addiction
      • Surveyed Psychiatrists’ Satisfaction with the Performance of Key Therapies for Opioid Addiction on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
      • Surveyed Psychiatrists’ Satisfaction with the Performance of Key Therapies for Opioid Addiction on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
      • Surveyed Psychiatrists’ Ascribed Level of Unmet Need Across Key Efficacy Attributes in Opioid Addiction: United States
      • Surveyed Psychiatrists’ Ascribed Level of Unmet Need Across Key Efficacy Attributes in Opioid Addiction: Europe
      • Surveyed Psychiatrists’ Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Opioid Addiction: United States
      • Surveyed Psychiatrists’ Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Opioid Addiction: Europe
      • Surveyed Psychiatrists’ Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Opioid Addiction: United States
      • Surveyed Psychiatrists’ Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Opioid Addiction: Europe
      • Key Findings: Unmet Need in Opioid Addiction and Related Indications
      • Surveyed Psychiatrists’ Ascribed Level of Unmet Need in Opioid Addiction and Related Indications: United States
      • Surveyed Psychiatrists’ Ascribed Level of Unmet Need in Opioid Addiction and Related Indications: Europe
    • Opportunity Analysis
      • Areas of Opportunity in the Opioid Addiction Market and Emerging Therapy Insights
        • Opportunity: A Novel Therapy Offering Greater Reduction in Opioid Use in Patients with Opioid Addiction
        • Opportunity: A New Therapy for Opioid Addiction with a More-Convenient Delivery Profile
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
        • Attributes and Attribute Levels
      • Attribute Importance and Part-Worth Utilities
        • Opioid Addiction Target Product Profile: Attribute Importance
        • % of Urine Samples Negative for Opioids at Study End
        • % of Patients with Continuous Abstinence from Opioids at Study End
        • % of Opioid-Dependent Patients Completing the Study
        • Reduction in Patient-Rated Craving for Opioids at Study End: 100 mm VAS
        • Risk of Abuse, Misuse, and/or Diversion
        • Delivery Burden: Dosing Frequency and Formulation
        • Price per Treated Day
      • Conjoint Analysis-Based Simulations of Market Scenarios
        • Opioid Addiction Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 1
        • Opioid Addiction Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 1
        • Opioid Addiction Market Simulations: Target Product Profiles Included in Scenario 1
        • Opioid Addiction Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 2
        • Opioid Addiction Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 2
        • Opioid Addiction Market Simulations: Target Product Profiles Included in Scenario 2
    • Appendix
      • Key Abbreviations
      • Bibliography

Author(s): Niyati Khetarpal, Ph.D

"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.”