The Global Market for Pain Management Drugs and Devices

Jan 08, 2013, 08:46 ET from Reportlinker

NEW YORK, Jan. 8, 2013 /PRNewswire/ -- Reportlinker.com announces that a new market research report is available in its catalogue:

The Global Market for Pain Management Drugs and Devices

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INTRODUCTION

STUDY GOALS AND OBJECTIVES This BCC Research report, The Global Market for Pain Management Drugs and Devices, provides an overview of products included in this market, and detailed analyses of markets and competitive environments. The study includes information about significant products, players, issues and trends, regulatory issues, and other information affecting the pain management industry.REASONS FOR DOING THE STUDY This study will provide the reader with the knowledge to adequately view and assess pain management and the problems that the healthcare industry faces as well as provide insights into the market potentials. This covers a wide variety of treatments and products that many people worldwide rely on.SCOPE AND FORMAT This BCC Research report is designed to be a helpful business tool that will provide a thorough evaluation of the markets for pain management. The geographical scope of this study is global with a U.S. emphasis. This study will address acute versus chronic pain, treatments, and regulatory issues facing healthcare workers. Also provided is detailed information based on product categories, use of products, forecasts, and competitive analyses.

The report identifies two general segments of pain management:- Pharmaceuticals.- Devices.

Within the pharmaceuticals segment several sub-segments are discussed in detail including:

- Narcotic pain management.

- Non-narcotic pain management.

- Antimigraine treatments.

- Anesthetics.

- Other drugs (including fibromyalgia treatments).

The device segment covers several product lines and specifically targets the largest product segments including:- TENS and neuromuscular stimulators.- Spinal cord stimulators.- Other products (including electromagnetic therapies and other treatments).

Each market segment provides detailed information based on product categories, product use, forecasts, and competitive analyses.

METHODOLOGY The information for this BCC report was obtained through primary and secondary data-collection methods. Primary methods included interviews with approximately 35 key executives, physicians, nurses, product managers, and other professionals involved in the pain treatment industry. Secondary methods included published literature in the area of pain management, investment reports, company literature, and various related journals.

Market data for this report pertains to the global market and uses U.S. dollars at the manufacturers' level. The base year of the report is 2012, with historical data provided for 2008 through 2011, and forecast data provided through 2017. Historical, base year and forecast data are provided for each market segment of the report. Growth rates are determined through a compilation of data, including past trends, future trends, demographics, incidence, mortality, products in research and development, and current product growth, etc. Competitor market share estimates are provided for each market segment for the 2012 base year.

ANALYST CREDENTIALS

Melissa Elder is an experienced healthcare market analyst specializing in prescription and over-the-counter pharmaceuticals, medical devices, and emerging healthcare technologies. Ms. Elder has nearly 20 years of experience in the healthcare industry, specializing in market research for the past 14 years. This experience has given her substantial insight into pharmaceutical market analysis. Her work in the medical community, including emergency room medical training and healthcare information system coordination, has enhanced her ability to provide insight into many healthcare markets.

REPORT HIGHLIGHTS

This report provides:- An overview of the global market for pain management drugs, which will address acute vs. chronic pain, treatments, and issues facing healthcare workers.- Analyses of global market trends, with data from 2012, and projections of compound annual growth rates (CAGRs) through 2017.- Examination of product categories, use of products, and the competitive landscape.- Coverage of several significant market trends, including undertreatment issues, professional issues, managed care pain issues, trends in new therapies, product pipelines, generic participation, pain research, drug delivery, and patent expirations.- Discussion of new regulatory requirements.- Comprehensive company profiles of major players in the industry.

TABLE OF CONTENTS CHAPTER 1 INTRODUCTION 1

STUDY GOALS AND OBJECTIVES 1

REASONS FOR DOING THE STUDY 1

SCOPE AND FORMAT 1

METHODOLOGY 2

ANALYST CREDENTIALS 2

RELATED BCC STUDIES 2

BCC ON-LINE SERVICES 2

DISCLAIMER 3

CHAPTER 2 SUMMARY 5OVERVIEW 5GENERAL PAIN TERMINOLOGY 5MAJOR MARKETS SUMMARY 6SUMMARY TABLE GLOBAL PAIN MANAGEMENT PHARMACEUTICALS AND DEVICESMARKET, 2012 AND 2017 ($ MILLIONS) 7SUMMARY FIGURE GLOBAL PAIN MANAGEMENT PHARMACEUTICALS AND DEVICESMARKET, 2012 AND 2017 ($ MILLIONS) 7MARKET TRENDS 7UNDER-TREATMENT ISSUES 8PROFESSIONAL PAIN TREATMENT ISSUES 8ACCESS TO CARE 8GLOBAL HEALTHCARE SYSTEMS 8FDA APPROVAL REQUIREMENTS FOR PAIN THERAPIES 8DRUG DELIVERY SYSTEMS 9COMPETITORS 9

CHAPTER 3 INDUSTRY OVERVIEW 11

HISTORY OF PAIN AND PAIN TREATMENT 11

THE PERCEPTION OF PAIN 12

Types of Pain 12

Acute Pain 12

Chronic Pain 13

ASSESSMENT OF PAIN 13

Subjective 13

Objective 13

TABLE 1 OBJECTIVE SIGNS OF PAIN 14

HOW PAIN IS DIAGNOSED 14

THERMOGRAPHY 15

HOW PAIN IS TREATED 15

FIGURE 1 PAIN-MANAGEMENT TECHNIQUES 15

DEMOGRAPHICS AND AGING POPULATIONS 20

Global Demographics 20

TABLE 2 ESTIMATED GLOBAL POPULATION AND ANNUAL GROWTH BY SELECTED AGE

GROUP AND SELECTED YEARS, THROUGH 2030 (MILLIONS) 21

FIGURE 2 ESTIMATED GLOBAL POPULATION BY SELECTED AGE GROUP AND SELECTED

YEARS, 2000-2030 (MILLIONS) 21

TABLE 3 GLOBAL POPULATION BY SELECTED COUNTRY, THROUGH 2015 (MILLIONS) 22

FIGURE 3 GLOBAL POPULATION BY SELECTED COUNTRY, 2010 AND PROJECTED 2015

(MILLIONS) 22

Global Life Expectancy 23

TABLE 4 GLOBAL LIFE EXPECTANCY AT BIRTH BY SELECTED COUNTRY, 1980 AND 2010

(YEARS) 23

FIGURE 4 GLOBAL LIFE EXPECTANCY AT BIRTH BY SELECTED COUNTRY, 1980 AND 2010

(YEARS) 24

GLOBAL PAIN MANAGEMENT 24

FIGURE 5 GLOBAL CANCER DEATHS BY TYPE, 2008 (THOUSANDS) 25

INCIDENCE OF PAIN 26

PREVALENCE OF PAIN 26

Severe Headache or Migraine, Low Back, and Neck Pain 26

TABLE 5 SEVERE HEADACHE OR MIGRAINE, LOW BACK PAIN, AND NECK PAIN AMONG

ADULTS 18 YEARS OF AGE AND OVER*, 2005-2009 (%) 26

FIGURE 6 SEVERE HEADACHE OR MIGRAINE, LOW BACK PAIN, AND NECK PAIN AMONG

ADULTS 18 YEARS OF AGE AND OVER*, 2005-2009 (%) 27

Orthopedic Pain 28

Osteoarthritis 28

Rheumatoid Arthritis 28

Ankylosing Spondylitis 28

Fibromyalgia 29

Gout 29

Scleroderma 29

Lupus 29

Bursitis and Tendonitis 29

Osteoporosis 30

Low Bone Mass 30

TABLE 6 ESTIMATED* PREVALENCE/INCIDENCE OF CONDITIONS AFFECTING THE

WORLDWIDE ORTHOPEDIC INDUSTRY, AVERAGE FIGURE, 2008-2010 30

FIGURE 7 ESTIMATED* PREVALENCE/INCIDENCE OF CONDITIONS AFFECTING THE

WORLDWIDE ORTHOPEDIC INDUSTRY, AVERAGE FIGURE 2008–2010 31

Cancer Pain 31

FIGURE 8 CAUSES OF CANCER PAIN 32

Pain Management in Cancer 33

TABLE 7 CANCER PAIN MEDICATION 33

Description of Some of Key Medications for Cancer Pain Control 34

Morphine 34

Fentanyl 34

Hydromorphone 34

Methadone 34

Buprenorphine 35

Oxycodone 35

Tapentadol 35

HIV/AIDS Related Pain 35

TABLE 8 ESTIMATED HIV REPORTED CASES BY REGION, 2011 36

FIGURE 9 ADULT PREVALENCE RATE, 2011 (%) 36

Burn Pain 36

Burn Classifications 37

TABLE 9 BURN CLASSIFICATIONS 37

Stages of Burn Healing 38

Challenges Associated with Burn Pain 39

Burn Pain Management 39

FIGURE 10 BURN PAIN MANAGEMENT APPROACH 40

Dental Pain 40

Treatment for Dental Pain 41

Obstetrics Pain 41

TABLE 10 BIRTH RATES AND BIRTHS BY COUNTRY, 2010 ESTIMATES 42

FIGURE 11 BIRTH RATES AND BIRTHS BY COUNTRY, 2010 ESTIMATES 42

Surgical pain 42

U.S. Surgical Procedures 43

TABLE 11 U.S. SURGICAL PROCEDURES 44

Global Surgical Procedures 44

TABLE 12 SELECT SURGICAL PROCEDURES FOR GERMANY, UNITED KINGDOM, AND

FRANCE 45

GENDER AND PAIN 45

TABLE 13 PAIN BY SELECTED CATEGORY AND GENDER IN THE 18+ U.S. POPULATION*

(THOUSANDS) 46

FIGURE 12 PAIN BY SELECTED CATEGORY AND GENDER IN THE 18+ U.S. POPULATION*

(THOUSANDS) 47

OTHER INFLUENCES DETERMINING HOW PAIN IS FELT AMONG INDIVIDUALS 47

Objective Pain Measurement 48

PEDIATRIC PAIN 48

CHAPTER 4 INDUSTRY TRENDS 51OVERVIEW 51UNDERTREATMENT ISSUES 51TREATMENT OF PAIN AND ISSUES FACING THE PROFESSIONAL SEGMENT 53TABLE 14 AVAILABILITY OF EDUCATION IN PAIN MANAGEMENT BY SELECTREGION/COUNTRY 55PRESCRIPTION DRUG MONITORING PROGRAMS 56TABLE 15 TOTAL NUMBER OF ABUSE TREATMENT FACILITIES AND CLIENTS, 2000–2010 56FIGURE 13 TOTAL NUMBER OF ABUSE TREATMENT FACILITIES, 2000–2010 56FIGURE 14 TOTAL NUMBER OF ABUSE TREATMENT CLIENTS, 2000–2010 57TABLE 16 BENEFITS OF PRESCRIPTION MONITORING PROGRAMS FOR MEDICAL BOARDS 58TABLE 17 STATES WITH ELECTRONIC PRESCRIPTION MONITORING PROGRAMS 58TABLE 18 STATE CONTROLLED SUBSTANCES SCHEDULING AUTHORITIES AND OTHERCONTACT INFORMATION 60TABLE 19 NURSE CONTINUING EDUCATION REQUIREMENTS FOR PAIN MANAGEMENT, BYREQUIRING STATE 73ACCESS TO CARE 73PHYSICIAN TO PATIENT RATIOS 74TABLE 20 PHYSICIANS PER 1,000 POPULATION BY YEAR AND COUNTRY (THOUSANDS) 74FIGURE 15 PHYSICIANS PER 1,000 POPULATION BY COUNTRY, 2010* 75TABLE 21 NUMBER OF PHYSICIAN PER 100,000 RESIDENT POPULATION, UNITED STATES,2009 76FIGURE 16 NUMBER OF PHYSICIANS PER 100,000 RESIDENT POPULATION, UNITED STATES2009 76ACCESS TO PALLIATIVE CARE 77AVAILABILITY OF MEDICATIONS 78TABLE 22 AVAILABILITY OF INJECTABLE MORPHINE BY COUNTRY 78TABLE 23 AVAILABILITY OF ORAL MORPHINE IN HOSPICE-TYPE SETTINGS BY COUNTRY 79GOVERNMENT RESTRICTIONS AND SUPPORT 80Drug Supply 80Single Convention on Narcotic Drugs 81Government Subsidies 81PUBLIC HEALTHCARE SYSTEMS AROUND THE WORLD 81TABLE 24 WORLD HEALTH ORGANIZATION RANKING OF HEALTHCARE SYSTEMS, TOP 50(2000) 82RISING HEALTHCARE COSTS 83TABLE 25 HEALTH EXPENDITURES AS PERCENTAGE OF GDP BY COUNTRY, 1980 TO 2010 83AVERAGE LENGTH OF STAY 83TABLE 26 HOSPITAL USAGE STATISTICS, AVERAGE 2000-2010 (DAYS) 84FIGURE 17 HOSPITAL USAGE STATISTICS (DAYS) 84MANAGED CARE PAIN MANAGEMENT ISSUES 85FDA APPROVAL REQUIREMENTS FOR PAIN THERAPIES 85NEW RULES AND LEGISLATION 86Risk Evaluation and Mitigation Strategy (REMS) 86TABLE 27 LIST OF EXTENDED-RELEASE AND LONG-ACTING OPIOID PRODUCTS REQUIREDTO HAVE AN OPIOID REMS, BRAND NAME PRODUCTS 86TABLE 28 LIST OF EXTENDED-RELEASE AND LONG-ACTING OPIOID PRODUCTS REQUIREDTO HAVE AN OPIOID REMS, GENERIC NAME PRODUCTS 87TABLE 29 LIST OF TRANSMUCOSAL IMMEDIATE-RELEASE FENTANYL PRODUCTSREQUIRED TO HAVE TIRF REMS ACCESS PROGRAM 88Acetaminophen and FDA Changes 88TABLE 30 LIST OF MARKETED ACETAMINOPHEN-CONTAINING PRESCRIPTION PRODUCTS 89DRUG DELIVERY SYSTEMS 90ORAL AND EXTENDED RELEASE 90TOPICAL AND TRANSDERMAL 90INTRAVENOUS 91INTRANASAL 91PATIENT-CONTROLLED ANALGESIA 91IONTOPHORESIS 91TABLE 31 ADVANTAGES OF IONTOPHORETIC DRUG DELIVERY 92ELECTROMECHANICAL TRANSPORT 92

CHAPTER 5 TREATING PAIN 94

PHARMACEUTICAL PAIN MANAGEMENT 94

PRESCRIPTION PAIN MANAGEMENT PRODUCTS 94

TABLE 32 RECENT FDA APPLICATIONS/APPROVALS, JANUARY 2010-OCTOBER 2012 94

Analgesic Drugs 96

Non-Narcotic 97

Narcotic 97

Full and Partial Agonists 99

Agonist-Antagonists 100

Nonsteroid Anti-inflammatory Drugs 101

Anti-migraine Drugs 102

Antidepressant, Anticonvulsants, and Other Pain Relieving Drugs 103

ANESTHETICS 103

General 103

TABLE 33 MOST COMMONLY USED GENERAL ANESTHETIC AGENTS 104

Local/Regional 105

Topical 105

OVER-THE-COUNTER PAIN MANAGEMENT PRODUCTS 105

ANALGESIC DRUGS 105

TABLE 34 ACETAMINOPHEN AND ACETAMINOPHEN COMBINATION PRODUCTS 106

NONSTEROID ANTI-INFLAMMATORY DRUGS 106

Aspirin Products and Aspirin Combination Products 107

TABLE 35 ASPIRIN AND ASPIRIN COMBINATION PRODUCTS 107

Ibuprofen and Ibuprofen Combination Products 107

TABLE 36 IBUPROFEN AND IBUPROFEN COMBINATION PRODUCTS 108

Ketoprofen Products 108

TABLE 37 KETOPROFEN PRODUCTS 108

Naproxen Compounds 108

TABLE 38 OTC NONSTEROID ANTI-INFLAMMATORIES 109

ANTI-MIGRAINE DRUGS 109

TABLE 39 ANTI-MIGRAINE PRODUCTS 109

TOPICAL ANESTHETIC DRUGS 109

TABLE 40 TOPICAL ANESTHETIC PRODUCTS 110

PAIN MANAGEMENT DEVICES 110

TRANSCUTANEOUS ELECTRICAL NERVE STIMULATORS 111

PAIN TEM 112

SPINAL CORD STIMULATORS 112

NEUROMUSCULAR STIMULATORS 113

OTHER PAIN MANAGEMENT DEVICES 114

Electromagnetic Therapy 115

PAIN MANAGEMENT PROCEDURES: STEROIDS, ENDOSCOPY, FLUOROSCOPY 116

ALTERNATIVE METHODS OF PAIN MANAGEMENT 116

PSYCHOLOGICAL THERAPIES 118

Biofeedback 118

Hypnosis 118

Behavior Modification/Operant Conditioning 119

Relaxation and Stress Management Training 119

Imagery 120

Autogenic Training 120

Psychosocial Interventions 120

Distraction and Reframing 120

PHYSICAL THERAPIES 121

Ice 121

Warm Bath 121

Massage 121

Joint Mobilization 122

Manipulation 122

Traction 122

Acupuncture/Acupressure 122

Laser Therapy 123

Surgery 124

Radiation Therapy 124

Radio-Frequency Neuroablation, Epiduroscopy 124

TABLE 41 UNITED STATES: ADULTS 18 YEARS AND OVER WHO USED COMPLEMENTARY

AND ALTERNATIVE MEDICINE (CAM) IN THE PAST 12 MONTHS BY TYPE AND THERAPY,

2002-2012 (THOUSANDS OF PEOPLE) 125

FIGURE 18 UNITED STATES: ADULTS 18 YEARS AND OVER WHO USED COMPLEMENTARY

AND ALTERNATIVE MEDICINE (CAM) IN THE PAST 12 MONTHS BY TYPE AND THERAPY,

2002-2012 (THOUSANDS OF PEOPLE) 125

PAIN MANAGEMENT SERVICES AND ORGANIZATIONS 126

HOME CARE 126

HOSPICE 127

FIGURE 19 TOTAL HOSPICE PATIENTS SERVED BY YEAR, 2006-2010 (TOTAL PATIENTS

SERVED, ESTIMATE) 128

TABLE 42 HOSPICE STATISTICS, PATIENTS BY CHARACTERISTICS, 2009 AND 2010 (% OF

TOTAL) 129

FIGURE 20 TOTAL HOSPICE PATIENTS BY GENDER, 2009 AND 2010 (% OF TOTAL) 129

FIGURE 21 TOTAL HOSPICE PATIENTS BY AGE, 2009 AND 2010 (% OF TOTAL) 130

TABLE 43 HOSPICE STATISTICS, PATIENTS BY PRIMARY DIAGNOSIS (% OF TOTAL) 130

FIGURE 22 TOTAL HOSPICE PATIENTS BY PRIMARY DIAGNOSIS, 2009 AND 2010 (% OF

TOTAL) 131

NATIONAL HOSPICE AND PALLIATIVE CARE ORGANIZATION 132

TABLE 44 NHPCO COMMITTEES AND TASK FORCES 132

HOSPITALS 133

TABLE 45 ESTIMATED NUMBER OF REGISTERED HOSPITALS BY SELECTED COUNTRY, 2010

ESTIMATES 133

TABLE 46 TOTAL NUMBER OF REGISTERED U.S. HOSPITALS BY TYPE, 2010 134

Hospital Departments 134

Emergency Rooms (ER) 134

Critical-Care Units (CCU) 134

PAIN CLINICS 135

SKILLED NURSING FACILITIES 136

CHAPTER 6 PRESCRIPTION PAIN MANAGEMENT MARKET SIZE AND ANALYSIS 138TOTAL MARKET 138PRESCRIPTION PAIN MARKETS BY PRODUCT TYPE 138TABLE 47 GLOBAL PRESCRIPTION PAIN MANAGEMENT PHARMACEUTICALS MARKET ATMANUFACTURERS' SALES LEVELS, THROUGH 2017 ($ MILLIONS) 139FIGURE 23 GLOBAL PRESCRIPTION PAIN MANAGEMENT PHARMACEUTICALS MARKET ATMANUFACTURERS' SALES LEVELS, 2008-2017 ($ MILLIONS) 139NARCOTIC ANALGESICS 139NON-NARCOTIC ANALGESICS 140ANTIMIGRAINE AGENTS 140ANESTHETICS 140OTHER DRUG CLASSES 141MARKET PARTICIPANTS 141NARCOTIC/NON-NARCOTIC MARKET SHARE 141TABLE 48 PRESCRIPTION NARCOTIC AND NON-NARCOTIC MANUFACTURER MARKETSHARE BY REVENUE, 2012 ($ MILLIONS) 142FIGURE 24 PRESCRIPTION NARCOTIC AND NON-NARCOTIC MANUFACTURER MARKETSHARE BY REVENUE, 2012 ($ MILLIONS) 142MIGRAINE TREATMENT MARKET SHARE 142TABLE 49 PRESCRIPTION ANTI-MIGRAINE DRUG MANUFACTURER MARKET SHARE BYREVENUE, 2012 ($ MILLIONS/%) 143FIGURE 25 PRESCRIPTION ANTI-MIGRAINE DRUG MANUFACTURER MARKET SHARE BYREVENUE, 2012 (%) 144ANESTHETIC MARKET SHARE 144TABLE 50 PRESCRIPTION ANESTHETIC MANUFACTURER MARKET SHARE BY REVENUE,2012 ($ MILLIONS) 145FIGURE 26 PRESCRIPTION ANESTHETIC MANUFACTURER MARKET SHARE BY REVENUE,2012 (%) 145FUTURE MARKET ANALYSIS 145

CHAPTER 7 PAIN MANAGEMENT DEVICE MARKET SIZE AND ANALYSIS 147

TOTAL PAIN MANAGEMENT DEVICE MARKET 147

PAIN MARKETS BY PRODUCT TYPE 147

TABLE 51 GLOBAL PAIN MANAGEMENT DEVICES MARKET BY PRODUCT TYPE, THROUGH

2017 ($ MILLIONS) 148

FIGURE 27 GLOBAL PAIN MANAGEMENT DEVICES MARKET BY PRODUCT TYPE, 2008-2017

($ MILLIONS) 148

SPINAL CORD STIMULATORS 148

NEUROSTIMULATOR/TENS UNITS 149

OTHER PAIN TREATMENT DEVICES 149

MARKET PARTICIPANTS 149

NEUROMUSCULAR STIMULATOR/TENS MARKET SHARE 149

TABLE 52 GLOBAL NEUROMUSCULAR STIMULATOR/TENS—ELECTROTHERAPY

DEVICES—MANUFACTURER MARKET SHARE, 2012 ($ MILLIONS) 150

FIGURE 28 GLOBAL NEUROMUSCULAR STIMULATOR/TENS—ELECTROTHERAPY

DEVICES—MANUFACTURER MARKET SHARE, 2012 (%) 150

SPINAL CORD STIMULATOR MARKET SHARE 150

TABLE 53 GLOBAL SPINAL CORD STIMULATOR MANUFACTURER MARKET SHARE, 2012 ($

MILLIONS) 151

FIGURE 29 GLOBAL SPINAL CORD STIMULATOR MANUFACTURER MARKET SHARE, 2012 (%) 151

FUTURE MARKET ANALYSIS 151

CHAPTER 8 TOTAL MARKET SUMMARY 153TOTAL PAIN MANAGEMENT MARKET 153TABLE 54 PAIN MANAGEMENT PHARMACEUTICALS AND DEVICES MARKET BY REVENUE,THROUGH 2017 ($ MILLIONS) 153FIGURE 30 PAIN MANAGEMENT PHARMACEUTICALS AND DEVICES MARKET BY REVENUE,2008-2017 ($ MILLIONS) 153MARKET PERCENTAGE BY PRODUCT TYPE 154TABLE 55 PERCENT DISTRIBUTION OF THE GLOBAL PAIN MANAGEMENT MARKET BYSEGMENT, 2012 (%/$ MILLIONS) 154FIGURE 31 PERCENT DISTRIBUTION OF THE GLOBAL PAIN MANAGEMENT MARKET BYSEGMENT, 2012 (%) 154MARKETS BY WORLD REGION 155TABLE 56 DISTRIBUTION OF GLOBAL PAIN MANAGEMENT REVENUES BY REGION, 2012(%/$ MILLIONS) 156FIGURE 32 PERCENTAGE DISTRIBUTION OF GLOBAL PAIN MANAGEMENT SHARES BYREGION, 2012 (%) 156

CHAPTER 9 INDUSTRY DEVELOPMENTS 158

TIMELINE OF RECENT EVENTS AND DEVELOPMENTS 158

THE PIPELINE 159

TABLE 57 SELECTED PAIN-MANAGEMENT DRUG PIPELINES 159

NEW DEVELOPMENTS IN BREAKTHROUGH CANCER PAIN 162

NEW DEVELOPMENTS IN TREATING NEUROPATHIC PAIN 162

DEVELOPMENTS IN OPIOID-INDUCED CONSTIPATION AND REDUCED COMPLIANCE 163

FUTURE OF PAIN RESEARCH 164

PATIENT OUTCOMES RESEARCH 166

SELECTED PAIN-RELATED ACQUISITIONS AND ALLIANCES 166

JANUARY-OCTOBER 2012 166

2000-2011 167

DRUG PATENTS FOR SELECTED THERAPIES 167

TABLE 58 U.S. PATENT EXPIRATION DATES FOR SELECT PAIN DRUGS 167

IMPACT OF GENERIC PARTICIPATION 168

TABLE 59 FIRST TIME PRESCRIPTION GENERIC PAIN MANAGEMENT AND APPROVALS,

JANUARY 2004-OCTOBER 2012 169

CHAPTER 10 COMPANY PROFILES 174PHARMACEUTICAL AND DEVICE PAIN MANAGEMENT MANUFACTURERS 174ABBOTT LABORATORIES 174ASTRAZENECA 174BAXTER INTERNATIONAL INC. 175DJO GLOBAL, INC. 175ELI LILLY & CO. 175ENDO PHARMACEUTICALS, INC. 176GLAXOSMITHKLINE 176JOHNSON & JOHNSON 177MEDTRONIC, INC. 178MERCK & CO. INC. 178NOVARTIS INTERNATIONAL AG 179PFIZER 179PURDUE PHARMACEUTICALS LP 180ST. JUDE MEDICAL, INC. 180

CHAPTER 11 APPENDIX I: SELECTED PAIN MANAGEMENT CLINICS-UNITED STATES-BY

STATE 183

ALABAMA PAIN CLINICS 183

CALIFORNIA PAIN CLINICS 184

COLORADO PAIN CLINICS 192

DELAWARE PAIN CLINICS 193

FLORIDA PAIN CLINICS 193

HAWAII PAIN CLINICS 199

IOWA PAIN CLINICS 199

MAINE PAIN CLINICS 200

NEVADA PAIN CLINICS 200

OREGON PAIN CLINICS 201

PENNSYLVANIA PAIN CLINICS 202

RHODE ISLAND PAIN CLINICS 205

SOUTH DAKOTA PAIN CLINICS 205

TEXAS PAIN CLINICS 206

WASHINGTON PAIN CLINICS 208

CHAPTER 12 APPENDIX II: GLOBAL SELECTED PAIN MANAGEMENT CLINICS, BY COUNTRY 212ARGENTINA PAIN CLINICS 212AUSTRALIA PAIN CLINICS 213BRAZIL PAIN CLINICS 214GERMANY PAIN CLINICS 215INDIA PAIN CLINICS 215ITALY PAIN CLINICS 218SINGAPORE PAIN CLINICS 218UNITED KINGDOM PAIN CLINICS 219CHAPTER 13 APPENDIX III: U.S. PAIN SOCIETIES AND ASSOCIATIONS 222

CHAPTER 14 APPENDIX IV: INTERNATIONAL ASSOCIATIONS AND ORGANIZATIONS 224

CHAPTER 15 APPENDIX V: COMPANY NAMES AND ADDRESSES 226PAIN MANAGEMENT PHARMACEUTICAL MANUFACTURERS 226

LIST OF TABLES SUMMARY TABLE GLOBAL PAIN MANAGEMENT PHARMACEUTICALS AND DEVICES MARKET,

2012 AND 2017 ($ MILLIONS) 7

TABLE 1 OBJECTIVE SIGNS OF PAIN 14

TABLE 2 ESTIMATED GLOBAL POPULATION AND ANNUAL GROWTH BY SELECTED AGE

GROUP AND SELECTED YEARS, THROUGH 2030 (MILLIONS) 21

TABLE 3 GLOBAL POPULATION BY SELECTED COUNTRY, THROUGH 2015 (MILLIONS) 22

TABLE 4 GLOBAL LIFE EXPECTANCY AT BIRTH BY SELECTED COUNTRY, 1980 AND 2010

(YEARS) 23

TABLE 5 SEVERE HEADACHE OR MIGRAINE, LOW BACK PAIN, AND NECK PAIN AMONG

ADULTS 18 YEARS OF AGE AND OVER*, 2005-2009 (%) 26

TABLE 6 ESTIMATED* PREVALENCE/INCIDENCE OF CONDITIONS AFFECTING THE

WORLDWIDE ORTHOPEDIC INDUSTRY, AVERAGE FIGURE, 2008-2010 30

TABLE 7 CANCER PAIN MEDICATION 33

TABLE 8 ESTIMATED HIV REPORTED CASES BY REGION, 2011 36

TABLE 9 BURN CLASSIFICATIONS 37

TABLE 10 BIRTH RATES AND BIRTHS BY COUNTRY, 2010 ESTIMATES 42

TABLE 11 U.S. SURGICAL PROCEDURES 44

TABLE 12 SELECT SURGICAL PROCEDURES FOR GERMANY, UNITED KINGDOM, AND

FRANCE 45

TABLE 13 PAIN BY SELECTED CATEGORY AND GENDER IN THE 18+ U.S. POPULATION*

(THOUSANDS) 46

TABLE 14 AVAILABILITY OF EDUCATION IN PAIN MANAGEMENT BY SELECT

REGION/COUNTRY 55

TABLE 15 TOTAL NUMBER OF ABUSE TREATMENT FACILITIES AND CLIENTS, 2000–2010 56

TABLE 16 BENEFITS OF PRESCRIPTION MONITORING PROGRAMS FOR MEDICAL BOARDS 58

TABLE 17 STATES WITH ELECTRONIC PRESCRIPTION MONITORING PROGRAMS 58

TABLE 18 STATE CONTROLLED SUBSTANCES SCHEDULING AUTHORITIES AND OTHER

CONTACT INFORMATION 60

TABLE 19 NURSE CONTINUING EDUCATION REQUIREMENTS FOR PAIN MANAGEMENT, BY

REQUIRING STATE 73

TABLE 20 PHYSICIANS PER 1,000 POPULATION BY YEAR AND COUNTRY (THOUSANDS) 74

TABLE 21 NUMBER OF PHYSICIAN PER 100,000 RESIDENT POPULATION, UNITED STATES,

2009 76

TABLE 22 AVAILABILITY OF INJECTABLE MORPHINE BY COUNTRY 78

TABLE 23 AVAILABILITY OF ORAL MORPHINE IN HOSPICE-TYPE SETTINGS BY COUNTRY 79

TABLE 24 WORLD HEALTH ORGANIZATION RANKING OF HEALTHCARE SYSTEMS, TOP 50

(2000) 82

TABLE 25 HEALTH EXPENDITURES AS PERCENTAGE OF GDP BY COUNTRY, 1980 TO 2010 83

TABLE 26 HOSPITAL USAGE STATISTICS, AVERAGE 2000-2010 (DAYS) 84

TABLE 27 LIST OF EXTENDED-RELEASE AND LONG-ACTING OPIOID PRODUCTS REQUIRED

TO HAVE AN OPIOID REMS, BRAND NAME PRODUCTS 86

TABLE 28 LIST OF EXTENDED-RELEASE AND LONG-ACTING OPIOID PRODUCTS REQUIRED

TO HAVE AN OPIOID REMS, GENERIC NAME PRODUCTS 87

TABLE 29 LIST OF TRANSMUCOSAL IMMEDIATE-RELEASE FENTANYL PRODUCTS REQUIRED

TO HAVE TIRF REMS ACCESS PROGRAM 88

TABLE 30 LIST OF MARKETED ACETAMINOPHEN-CONTAINING PRESCRIPTION PRODUCTS 89

TABLE 31 ADVANTAGES OF IONTOPHORETIC DRUG DELIVERY 92

TABLE 32 RECENT FDA APPLICATIONS/APPROVALS, JANUARY 2010-OCTOBER 2012 94

TABLE 33 MOST COMMONLY USED GENERAL ANESTHETIC AGENTS 104

TABLE 34 ACETAMINOPHEN AND ACETAMINOPHEN COMBINATION PRODUCTS 106

TABLE 35 ASPIRIN AND ASPIRIN COMBINATION PRODUCTS 107

TABLE 36 IBUPROFEN AND IBUPROFEN COMBINATION PRODUCTS 108

TABLE 37 KETOPROFEN PRODUCTS 108

TABLE 38 OTC NONSTEROID ANTI-INFLAMMATORIES 109

TABLE 39 ANTI-MIGRAINE PRODUCTS 109

TABLE 40 TOPICAL ANESTHETIC PRODUCTS 110

TABLE 41 UNITED STATES: ADULTS 18 YEARS AND OVER WHO USED COMPLEMENTARY AND

ALTERNATIVE MEDICINE (CAM) IN THE PAST 12 MONTHS BY TYPE AND THERAPY, 2002-2012

(THOUSANDS OF PEOPLE) 125

TABLE 42 HOSPICE STATISTICS, PATIENTS BY CHARACTERISTICS, 2009 AND 2010 (% OF

TOTAL) 129

TABLE 43 HOSPICE STATISTICS, PATIENTS BY PRIMARY DIAGNOSIS (% OF TOTAL) 130

TABLE 44 NHPCO COMMITTEES AND TASK FORCES 132

TABLE 45 ESTIMATED NUMBER OF REGISTERED HOSPITALS BY SELECTED COUNTRY, 2010

ESTIMATES 133

TABLE 46 TOTAL NUMBER OF REGISTERED U.S. HOSPITALS BY TYPE, 2010 134

TABLE 47 GLOBAL PRESCRIPTION PAIN MANAGEMENT PHARMACEUTICALS MARKET AT

MANUFACTURERS' SALES LEVELS, THROUGH 2017 ($ MILLIONS) 139

TABLE 48 PRESCRIPTION NARCOTIC AND NON-NARCOTIC MANUFACTURER MARKET SHARE

BY REVENUE, 2012 ($ MILLIONS) 142

TABLE 49 PRESCRIPTION ANTI-MIGRAINE DRUG MANUFACTURER MARKET SHARE BY

REVENUE, 2012 ($ MILLIONS/%) 143

TABLE 50 PRESCRIPTION ANESTHETIC MANUFACTURER MARKET SHARE BY REVENUE, 2012

($ MILLIONS) 145

TABLE 51 GLOBAL PAIN MANAGEMENT DEVICES MARKET BY PRODUCT TYPE, THROUGH

2017 ($ MILLIONS) 148

TABLE 52 GLOBAL NEUROMUSCULAR STIMULATOR/TENS—ELECTROTHERAPY

DEVICES—MANUFACTURER MARKET SHARE, 2012 ($ MILLIONS) 150

TABLE 53 GLOBAL SPINAL CORD STIMULATOR MANUFACTURER MARKET SHARE, 2012 ($

MILLIONS) 151

TABLE 54 PAIN MANAGEMENT PHARMACEUTICALS AND DEVICES MARKET BY REVENUE,

THROUGH 2017 ($ MILLIONS) 153

TABLE 55 PERCENT DISTRIBUTION OF THE GLOBAL PAIN MANAGEMENT MARKET BY

SEGMENT, 2012 (%/$ MILLIONS) 154

TABLE 56 DISTRIBUTION OF GLOBAL PAIN MANAGEMENT REVENUES BY REGION, 2012 (%/$

MILLIONS) 156

TABLE 57 SELECTED PAIN-MANAGEMENT DRUG PIPELINES 159

TABLE 58 U.S. PATENT EXPIRATION DATES FOR SELECT PAIN DRUGS 167

TABLE 59 FIRST TIME PRESCRIPTION GENERIC PAIN MANAGEMENT AND APPROVALS,

JANUARY 2004-OCTOBER 2012 169

LIST OF FIGURES SUMMARY FIGURE GLOBAL PAIN MANAGEMENT PHARMACEUTICALS AND DEVICES

MARKET, 2012 AND 2017 ($ MILLIONS) 7

FIGURE 1 PAIN-MANAGEMENT TECHNIQUES 15

FIGURE 2 ESTIMATED GLOBAL POPULATION BY SELECTED AGE GROUP AND SELECTED

YEARS, 2000-2030 (MILLIONS) 21

FIGURE 3 GLOBAL POPULATION BY SELECTED COUNTRY, 2010 AND PROJECTED 2015

(MILLIONS) 22

FIGURE 4 GLOBAL LIFE EXPECTANCY AT BIRTH BY SELECTED COUNTRY, 1980 AND 2010

(YEARS) 24

FIGURE 5 GLOBAL CANCER DEATHS BY TYPE, 2008 (THOUSANDS) 25

FIGURE 6 SEVERE HEADACHE OR MIGRAINE, LOW BACK PAIN, AND NECK PAIN AMONG

ADULTS 18 YEARS OF AGE AND OVER*, 2005-2009 (%) 27

FIGURE 7 ESTIMATED* PREVALENCE/INCIDENCE OF CONDITIONS AFFECTING THE

WORLDWIDE ORTHOPEDIC INDUSTRY, AVERAGE FIGURE 2008–2010 31

FIGURE 8 CAUSES OF CANCER PAIN 32

FIGURE 9 ADULT PREVALENCE RATE, 2011 (%) 36

FIGURE 10 BURN PAIN MANAGEMENT APPROACH 40

FIGURE 11 BIRTH RATES AND BIRTHS BY COUNTRY, 2010 ESTIMATES 42

FIGURE 12 PAIN BY SELECTED CATEGORY AND GENDER IN THE 18+ U.S. POPULATION*

(THOUSANDS) 47

FIGURE 13 TOTAL NUMBER OF ABUSE TREATMENT FACILITIES, 2000–2010 56

FIGURE 14 TOTAL NUMBER OF ABUSE TREATMENT CLIENTS, 2000–2010 57

FIGURE 15 PHYSICIANS PER 1,000 POPULATION BY COUNTRY, 2010* 75

FIGURE 16 NUMBER OF PHYSICIANS PER 100,000 RESIDENT POPULATION, UNITED STATES

2009 76

FIGURE 17 HOSPITAL USAGE STATISTICS (DAYS) 84

FIGURE 18 UNITED STATES: ADULTS 18 YEARS AND OVER WHO USED COMPLEMENTARY

AND ALTERNATIVE MEDICINE (CAM) IN THE PAST 12 MONTHS BY TYPE AND THERAPY,

2002-2012 (THOUSANDS OF PEOPLE)

125

FIGURE 19 TOTAL HOSPICE PATIENTS SERVED BY YEAR, 2006-2010 (TOTAL PATIENTS

SERVED, ESTIMATE) 128

FIGURE 20 TOTAL HOSPICE PATIENTS BY GENDER, 2009 AND 2010 (% OF TOTAL) 129

FIGURE 21 TOTAL HOSPICE PATIENTS BY AGE, 2009 AND 2010 (% OF TOTAL) 130

FIGURE 22 TOTAL HOSPICE PATIENTS BY PRIMARY DIAGNOSIS, 2009 AND 2010 (% OF TOTAL) 131

FIGURE 23 GLOBAL PRESCRIPTION PAIN MANAGEMENT PHARMACEUTICALS MARKET AT

MANUFACTURERS' SALES LEVELS, 2008-2017 ($ MILLIONS) 139

FIGURE 24 PRESCRIPTION NARCOTIC AND NON-NARCOTIC MANUFACTURER MARKET

SHARE BY REVENUE, 2012 ($ MILLIONS) 142

FIGURE 25 PRESCRIPTION ANTI-MIGRAINE DRUG MANUFACTURER MARKET SHARE BY

REVENUE, 2012 (%) 144

FIGURE 26 PRESCRIPTION ANESTHETIC MANUFACTURER MARKET SHARE BY REVENUE,

2012 (%) 145

FIGURE 27 GLOBAL PAIN MANAGEMENT DEVICES MARKET BY PRODUCT TYPE, 2008-2017 ($

MILLIONS) 148

FIGURE 28 GLOBAL NEUROMUSCULAR STIMULATOR/TENS—ELECTROTHERAPY

DEVICES—MANUFACTURER MARKET SHARE, 2012 (%) 150

FIGURE 29 GLOBAL SPINAL CORD STIMULATOR MANUFACTURER MARKET SHARE, 2012 (%) 151

FIGURE 30 PAIN MANAGEMENT PHARMACEUTICALS AND DEVICES MARKET BY REVENUE,

2008-2017 ($ MILLIONS) 153

FIGURE 31 PERCENT DISTRIBUTION OF THE GLOBAL PAIN MANAGEMENT MARKET BY

SEGMENT, 2012 (%) 154

FIGURE 32 PERCENTAGE DISTRIBUTION OF GLOBAL PAIN MANAGEMENT SHARES BY

REGION, 2012 (%) 156

To order this report:General_Medicine_and_Specialty_Medicine Industry: The Global Market for Pain Management Drugs and Devices

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