Complex regional pain syndrome (CRPS) is a debilitating pain condition characterized by persistent pain, typically in distal limbs, with intensity and symptomology disproportionate to any underlying injury. Symptoms include hyperalgesia and/or allodynia, changes to skin color and/or temperature, edema and/or sweating, motor dysfunction, and musculoskeletal atrophy in the affected limb. No therapies are approved specifically for the treatment of CRPS, leading physicians to use a host of pharmacological, behavioral, and interventional therapies to provide symptom relief, which often results in suboptimal analgesia. As such, the unmet need in this indication is extraordinarily high, providing ample commercial opportunity for a new drug to improve CRPS treatment.

QUESTIONS ANSWERED

  • In the absence of therapies with a CRPS label, what are surveyed pain specialists’ opinions of the relative performance of select therapies frequently prescribed for CRPS (e.g., pregabalin [Lyrica, generics], gabapentin, prednisolone, ketamine) on key efficacy, safety / tolerability, and convenience of administration attributes?
  • What are the top areas of unmet need and opportunity in CRPS?
  • Based on the responses of surveyed pain specialists, what level of unmet need exists on key drug performance attributes?
  • What trade-offs in drug price and drug performance across key drug attributes are surveyed pain specialists 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, United Kingdom, France, Germany

Primary research: Survey of 60 U.S. and 31 European pain specialists fielded in January and February 2020.

Key companies: Collegium Pharmaceutical, Merck, Mission Pharmacal, Pfizer, Purdue Pharma

Key drugs: Alendronate (Fosamax, Binosto, other brands, generics), dimethyl sulfoxide (topical), gabapentin (Neurontin, generics), ketamine (Ketalar, Spravato, generics), oxycodone ER (OxyContin, Xtampza ER, generics), prednisolone, pregabalin (Lyrica, generics)

Table of contents

  • Chronic Pain - Unmet Need - Detailed, Expanded Analysis: Complex Regional Pain Syndrome (US/FR/DEU/UK)
    • Executive Summary
      • Unmet Need - CRPS - Executive Summary - March 2020
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Rationale for Drug Selection
          • Products for CRPS 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 Pain Specialists' Prescribing Decisions in CRPS
        • Importance of Efficacy Attributes to Prescribing Decisions in CRPS: United States
        • Importance of Efficacy Attributes to Prescribing Decisions in CRPS: Europe
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in CRPS: United States
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in CRPS: Europe
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in CRPS: United States
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in CRPS: Europe
        • Importance of Nonclinical Factors to Prescribing Decisions in CRPS: United States
        • Importance of Nonclinical Factors to Prescribing Decisions in CRPS: 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 CRPS: United States
        • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in CRPS: Europe
      • Product Performance Against Treatment Drivers and Goals
        • Key Findings
        • Overall Performance of Key Therapies for CRPS: United States
        • Overall Performance of Key Therapies for CRPS: Europe
        • Mean Overall Performance of Key Therapies for CRPS: United States and Europe
        • Relative Performance of Key Therapies for CRPS Across Select Efficacy Attributes: United States
        • Relative Performance of Key Therapies for CRPS Across Select Efficacy Attributes: Europe
        • Relative Performance of Key Therapies for CRPS Across Select Safety and Tolerability Attributes: United States
        • Relative Performance of Key Therapies for CRPS Across Select Safety and Tolerability Attributes: Europe
        • Relative Performance of Key Therapies for CRPS Across Select Convenience of Administration Attributes: United States
        • Relative Performance of Key Therapies for CRPS Across Select Convenience of Administration Attributes: Europe
        • Relative Performance of Key Therapies for CRPS Across Select Nonclinical Attributes: United States
        • Relative Performance of Key Therapies for CRPS Across Select Nonclinical Attributes: Europe
      • Assessment of Unmet Need
        • Key Findings: Unmet Need in CRPS
        • Surveyed Pain Specialists’ Satisfaction with the Performance of Key Therapies for CRPS on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
        • Surveyed Pain Specialists’ Satisfaction with the Performance of Key Therapies for CRPS on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
        • Surveyed Pain Specialists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in CRPS: United States
        • Surveyed Pain Specialists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in CRPS: Europe
        • Surveyed Pain Specialists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in CRPS: United States
        • Surveyed Pain Specialists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in CRPS: Europe
        • Surveyed Pain Specialists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in CRPS: United States
        • Surveyed Pain Specialists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in CRPS: Europe
        • Surveyed Pain Specialists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in CRPS: United States
        • Surveyed Pain Specialists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in CRPS: Europe
        • Key Findings: Unmet Need in CRPS and Related Indications
        • Surveyed Pain Specialists' Ascribed Level of Unmet Need in CRPS and Related Indications: United States
        • Surveyed Pain Specialists' Ascribed Level of Unmet Need in CRPS and Related Indications: Europe
      • Opportunity Analysis
        • Areas of Opportunity in the CRPS Market and Emerging Therapy Insights
          • Opportunity: A New Analgesic with Decreased Rates of Neurological Side Effects
          • Opportunity: A New Analgesic Targeting Improved QOL
        • Lack of Opportunity in the CRPS Market and Emerging Therapy Insights
        • Target Product Profiles
          • Assessing Drug Development Opportunities
          • Target Product Profile Methodology
            • Attributes and Attribute Levels
            • Attributes of Key Current Therapies for CRPS
          • Attribute Importance and Part-Worth Utilities
            • CRPS Target Product Profile: Attribute Importance
            • Mean Point Reduction from Baseline in Pain Reduction (NRS Score)
            • Percentage of Patients Reporting “Much” or “Very Much Improved” in Pain Reduction (PGIC Score)
            • Mean Improvement in Quality of Life Score (Short Form 36)
            • Controlled Substance Restriction Imposed on Manufacture / Distribution / Prescription
            • Rate of Neurological Side Effects: % of Patients
            • Delivery Burden
            • Drug Price per Treated Day
          • Conjoint Analysis-Based Simulation of a Market Scenario
            • CRPS Market Simulation: Share of Preference of Target Product Profiles Included in the Market Scenario
            • CRPS Market Simulation: Likelihood to Prescribe Target Product Profiles Included in the Market Scenario
            • CRPS Market Simulation: Target Product Profiles Included in the Market Scenario
        • Appendix
          • Key Abbreviations
          • Bibliography

      Author(s): Joyce Spadafora, ALM

      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.


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