Chapter 1 Executive Summary
Chapter 2 Introduction
2.1 What is Pain?
2.1.1 Historical aspects of Pain
2.2 Pain Pathways
2.2.1 WHO Pain Ladder
2.3 Classification and Types of Pain
2.3.1 Acute Pain
2.3.2 Chronic Pain
2.3.2.1 Psychosocial Effects of Chronic Pain
2.3.2.2 The Financial Burden of Chronic Pain
2.3.2.3 Chronic Cancer Pain
2.3.2.4 Breakthrough Cancer Pain
2.4 Neuropathic Pain
2.4.1 Distinguishing Neuropathic Pain
2.5 Neurochemistry of Pain
2.5.1 Prostaglandins
2.5.2 Opioids
2.6 Pain treatments
2.7 OTC Pain relievers
Chapter 3 The World Pain Pharmaceutical Market
3.1 The World Pain Pharmaceutical Market Analysis
3.1.1 Forces Affecting the Pain Market
3.1.1.1 SWOT Analysis of the Pain Market
3.1.1.2 Market Drivers
3.1.1.3 Market Restraints
3.1.2 The Pain Market Suffered After the Withdrawal of COX-2 Inhibitors
3.1.3 Lack of Adequate Reimbursement Limits Potential of Pain Drugs
3.1.4 Patients Dependent on Reformulations of Existing Drugs
3.1.5 The Narcotics Market Suffers Greatly from Serious Side Effects
3.1.6 The Under-treatment of Pain
3.1.7 How Might These Findings Affect the Market for Pain Management Pharmaceuticals?
3.1.8 The Future of the Pain Market - Closing Comments
3.1.8.1 Shortcomings in the Attitude Towards Pain Management Illustrate the Need for the Proper Use of New and Existing Pain Management Therapies
3.1.8.2 Analgesic Effect of Established Drugs for Other Diseases Will Continue to be of Relevance to the Pain Management Market
3.1.8.3 Personalized Pain Management Therapy
Chapter 4 The Anti-Migraine Market
4.1 Headache Pain
4.1.1 Tension Headaches
4.1.2 Migraine Headaches
4.2 Prevalence of Migraine
4.2.1 Why Will the Prevalence of Migraine Increase?
4.3 Medications for the Prevention and Treatment of Migraine Pain
4.3.1 Acute Symptomatic relief of migraine pain
4.3.2 Selective Serotonin Agonists (Triptans)
4.3.2.1 Sumatriptan (Imitrex)
4.3.2.2 Rizatriptan (Maxalt)
4.3.2.3 Zolmitriptan (Zomig)
4.3.2.4 Eletriptan (Relpax)
4.3.2.5 Naratriptan (Naramig)
4.3.3 Ergots Used in the Treatment of Migraine Pain
4.3.4 Prophylatic Medicines
4.4 Top Five Products in the Market and Revenues, 2006
4.5 Market Analysis
4.5.1 GSK’s Blockbuster Migraine Drug Imitrex Faces Loss of Sales
4.5.1.1 GSK Waiting Approval for New Potential Anti-Migraine Blockbuster Drug
4.5.2 AstraZeneca’s Zomig – The New Market Leader Perhaps?
4.5.3 Relpax Shows Positive Revenue
4.5.4 What Does the Future Hold for Migraine Therapy?
4.5.5 What are the Unmet Needs in the Management of Migraine?
4.5.6 Why the Market will Grow
4.6 Pipeline Drugs for Treating Migraines
Chapter 5 Anti-Rheumatic Non-Steroidal Market
5.1 What is Arthritis?
5.1.1 Osteoarthritis
5.1.2 Rheumatoid Arthritis (RA)
5.1.2.1 Causes and Features of RA
5.1.2.2 Symptoms of RA
5.1.2.3 Diagnosing RA
5.2 Prevalence in the Seven Major Pharmaceutical Markets
5.2.1 Why will the Prevalence of Arthritis Increase
5.3 Forms of Drug Treatment
5.3.1 NSAIDs
5.3.2 COX-2
5.3.2.1 Side Effects
5.3.3 Analgesics
5.4 An Overview of the Top Five Drugs in the Anti-Rheumatic Non-Steroidal Market, 2006
5.4.1 Celebrex (Celecoxib, Pfizer)
5.4.2 Mobic (Meloxicam, Boehringer Ingelheim)
5.4.3 Voltaren (Diclofenac, Novartis)
5.4.4 Arthrotec (Diclofenac/Misoprostol, Pfizer)
5.4.5 Arcoxia (Etoricoxib, Merck & Co)
5.5 The Global Anti-Rheumatic Market Analysis
5.5.1 Pfizer’s Celebrex Dominates the Market, but will it last?
5.5.2 Mobic Suffers from Generic Competition
5.5.3 Arcoxia Has Reduced Gastro Intestinal Effects
5.5.4 Rises Predicted for Global Arthritis Market
5.5.5 NSAIDs – Coxibs (SWOT analysis)
5.6 Anti-Rheumatic Non-Steroidal Drugs in the Pipeline for Pain, 2007
Chapter 6 The Narcotics Market
6.1 Introduction to Opioids
6.1.1 Opioids Cellular Mechanism of Action
6.1.1.1 Peripheral and central opioid receptors
6.1.1.2 Peripheral opioid receptors and tissue injury
6.1.1.3 Tolerance at peripheral opioid receptors
6.1.1.4 Endogenous ligands of peripheral opioid receptors
6.1.1.5 Migration of opioid-producing cells to injured tissue
6.1.1.6 Opioid secretion and peripheral pain control
6.1.2 Analgesia
6.1.3 Euphoria
6.1.4 Respiratory depression
6.1.5 Effects on gastrointestinal tract
6.1.6 Tolerance and dependence
6.1.6.1 Tolerance
6.1.6.2 Physical dependence
6.1.7 Preclinical studies on peripheral opioid analgesics
6.1.7.1 Clinical studies on peripheral opioid analgesics
6.1.7.2 Perspectives
6.2 Regulatory limitations on the use and distribution of narcotic drugs
6.2.1 The International Narcotics Control Board
6.2.2 The WHO and the prevention of drug abuse
6.2.3 National drug policies and the control of medical agents with the potential for abuse
6.2.4 Does the control of substances with the potential for abuse limit their availability for legitimate use?
6.3 Commonly Used Opioid Analgesics
6.3.1 Morphine
6.3.2 Fentanyl
6.3.3 Oxycodone
6.3.4 Methadone
6.4 Top Products in the Narcotics Market
6.4.1 Oxycontin (Oxycodone, Purdue Pharma)
6.4.2 Duragesic (Fentanyl, J&J)
6.4.3 Actiq (Fentanyl, Cephalon)
6.5 The World Narcotics Market Analysis
6.5.1 Oxycontin – Associated with Abuse and Addiction
6.5.2 Duragesic – Defective Patches
6.5.3 Actiq Suffers Greatly from Generic Competition
6.6 Narcotic Drugs in the Pipeline for Pain
Chapter 7 Non-Narcotics Market
7.1 Non-Opioids
7.2 Non-steroidal anti-inflammatory drugs (NSAIDS)
7.2.1 Pharmacological actions
7.2.1.1 The prostaglandin pathway
7.3 The salicyclates and paracetamol
7.3.1 The salicylates
7.3.2 Pharmacokinetics
7.3.3 Common unwanted effects
7.3.4 Gastrointestinal disturbances
7.4 Top Four Products in the Non-Narcotics Market
7.4.1 Advil (Ibuprofen, Wyeth)
7.4.2 Tylenol (Paracetamol, J&J)
7.4.3 Aspirin Bayer (Acetylsalicylic Acid, Bayer)
7.4.4 Efferalgan (Paracetamol, Bristol-Myers Squibb)
7.5 The World Non-Narcotics Market Analysis
7.5.1 Tylenol Set to Reach Blockbuster Status
7.5.2 Aspirin Bayer – Huge Amount of Line Extensions Keeping Sales Up
7.5.3 Advil Set to Become Top Product in the Non-Narcotics Market
7.6 Non-Narcotics Drugs in the Pipeline for Pain
Chapter 8 Future Therapies
8.1 Cannabinoids and Pain: An Alternative to Opioids?
8.1.1 Experimentally Induced Acute Pain
8.1.2 Post Surgical Acute Pain
8.1.3 Chronic Pain
8.1.4 Sativex
8.1.4.1 European Phase III trials of Sativex
8.1.4.2 Sativex Approved for Cancer Pain
8.1.5 Cannabinoids and Pain: A Lucrative Market?
8.2 The Future of Pain Research
8.3 Advanced drug delivery
8.3.1 Delivery of poorly soluble drugs
8.3.2 Examples of Poorly Water Soluble Drugs
Chapter 9 Top Companies
9.1 Pfizer
9.2 Johnson & Johnson (J&J)
9.3 GlaxoSmithKline (GSK)
9.4 MundiPharma
9.5 Novartis
Chapter 10 Conclusion
10.1 The Pain Market is Headed for High Consistent Financial Growth
List of tables
Table 3.1 The Worldwide Pain Pharmaceutical Market Forecast ($m), 2007-2022
Table 3.2 Worldwide Pharmaceutical Pain Market Forecast by Area ($m), 2007-2022
Table 3.3 Top ten products in the pain market ($m), 2007
Table 3.4 A SWOT Chart for the Pain Market, 2007-2012
Table 4.1 Top five drugs in the anti-migraine market and 2006 sales
Table 4.2 The World Anti-Migraine Product Forecast ($m), 2007-2022
Table 4.3 Imitrex Forecast ($m), 2007-2012
Table 4.4 Zomig Forecast ($m), 2007-2012
Table 4.5 Relpax Forecast ($m), 2007-2012
Table 4.6 Anti-Migraine Pipeline Drugs for Pain, 2007
Table 5.1 Top Five Drugs in the Anti-Rheumatic Non-Steroidal Market and Revenue, 2006
Table 5.2 The Global Anti-Rheumatic Non-Steroidal Market Forecast ($m), 2007-2022
Table 5.3 Celebrex Forecast ($m), 2007-2012
Table 5.4 Mobic Forecast ($m), 2007-2012
Table 5.5 Arcoxia Forecast ($m), 2007-2012
Table 5.6 SWOT Analysis of the COX- Inhibitors
Table 5.7 Anti-Rheumatic Non-Steroidal Pipeline Drugs for Pain, 2007
Table 6.1 Top Four Products in the Narcotics Market and Revenue, 2006
Table 6.2 The World Narcotics Product Market Forecast ($m), 2007-2022
Table 6.3 Oxycontin Revenue Forecast ($m), 2007-2012
Table 6.4 Duragesic Revenue Forecast ($m), 2007-2012
Table 6.5 Actiq Revenue Forecast ($m), 2007-2012
Table 6.6 Narcotic Drugs in the Pipeline for Pain, 2007
Table 7.1 Top Four Products in the Non-Narcotics Market and Revenue, 2006
Table 7.2 The Total World Non-Narcotics Products Market Forecast ($m), 2007-2022
Table 7.3 Tylenol Market Forecast ($m), 2007-2012
Table 7.4 Aspirin Bayer Market Forecast ($m), 2007-2012
Table 7.5 Advil Market Forecast ($m), 2007-2012
Table 7.6 Non-Narcotics Drugs in the Pipeline for Pain, 2007
Table 9.1 Top five companies in the pain market ($bn), 2006
List of graphs
Graph 3.1 The World Pain Pharmaceutical Market Revenue Forecast ($m), 2007-2012
Graph 3.2 Pain Area Market Share (%), 2006, 2009 and 2012
Graph 4.1 Anti-Migraine World Market Forecast ($m), 2007-2012
Graph 4.2 Imitrex Revenue Forecast ($m), 2007-2012
Graph 4.3 Zomig Revenue Forecast ($m), 2007-2012
Graph 4.4 Relpax Revenue Forecast ($m), 2007-2012
Graph 5.1 The Anti-Rheumatic Non-Steroidal Market Revenue Forecast ($m), 2007-2012
Graph 5.2 Celebrex Revenue Forecast ($m), 2007-2012
Graph 5.3 Mobic Revenue Forecast ($m), 2007-2012
Graph 5.4 Arcoxia Revenue Forecast ($m), 2007-2012
Graph 6.1 The World Narcotics Revenue Forecast ($m), 2007-2012
Graph 6.2 Oxycontin Revenue Forecast ($m), 2007-2012
Graph 6.3 Duragesic Revenue Forecast ($m), 2007-2012
Graph 6.4 Actiq Revenue Forecast ($m), 2007-2012
Graph 7.1 The World Non-Narcotics Market Revenue Forecast ($m), 2007-2012
Graph 7.2 Tylenol Revenue Forecast ($m), 2007-2012
Graph 7.3 Aspirin Bayer Revenue Forecast ($m), 2007-2012
Graph 7.4 Advil Revenue Forecast ($m), 2007-2012
Graph 9.1 Pfizer's total sales ($m), 2001-2005
Graph 9.2 Pfizer's R&D expenditure ($m), 2001-2005
Graph 9.3 J&J’s Company Results ($bn), 2006
Graph 9.4 GSK’s Company Results ($bn), 2006
Graph 9.5 Novartis’ total sales ($m), 2001-2005
Graph 9.6 Novartis R&D expenditure ($m), 2001-2005
List of charts
Chart 3.1 Pain Area Market Share (%), 2006
Chart 3.2 Pain Area Market Share (%), 2009
Chart 3.3 Pain Area Market Share (%), 2012
Chart 3.3 Pain Area Market Share (%), 2017
Chart 3.3 Pain Area Market Share (%), 2022