PHARMACOLOGICAL AND DEVICE-BASED THERAPEUTIC APPROACHES TO PAIN MANAGEMENT

320 Pages | 63 Exhibits | 2006 Analysis | Forecasts Through 2011

OVERVIEW:
Pain is the single most common reason patients seek medical care, accounting for half of all physician office visits in the U.S. Each year, more than 25 million people in the U.S. experience acute pain as a result of injury or surgery; chronic pain affects more than 50 million people. In 2005, U.S. sales of pain management products (including prescription and nonprescription analgesics/ anesthetics as well as pain management devices) totaled approximately $20.4 billion. Prescription analgesics/anesthetics accounted for approximately 78% of total sales, followed by nonprescription analgesics/anesthetics with 16% and pain management devices with 6%. Over the forecast period covered by this report, sales are expected to increase at a compound annual rate of 6.6%, reaching approximately $29.9 billion in the year 2011.

This dynamic report from Medtech Insight includes analyses of products, technologies, current and forecast markets, competitors, and opportunities in the U.S. pharmacological and device-based pain management products market. Topics discussed in this report include over-the-counter and prescription pain management pharmaceuticals (e.g., ingested, inhaled, injected, transdermal, and transmucosal medications); pain management devices (e.g., analgesia infusion pumps and electrical stimulators); pain management services; and complementary/alternative medicine techniques in pain management.

TABLE OF CONTENTS:

EXECUTIVE SUMMARY

i.     Pain Management Products Market

ii.     Pain Management Pharmaceuticals

a.   Nonprescription Analgesics/Anesthetics

b.   Prescription Analgesics/Anesthetics

iii.   Pain Management Devices

a.   Transcutaneous Electrical Nerve Stimulators

b.   Neurostimulators

c.   Analgesia Infusion Pumps

d.   Other Devices Utilized for Pain Management

iv.   Pain Management Services

v.   Complementary and Alternative Medicine Techniques for Pain Management

 

Exhibit ES-1:   United States Population, by Selected Ages, 1990-2050

Exhibit ES-2:   Overview of the Joint Commission on Accreditation of Healthcare Organizations' Standards for Pain Assessment and Management

Exhibit ES-3:   Pain Management Products, Market Forecast, 2005-2011

Exhibit ES-4:   Nonprescription Analgesics/Anesthetics, Market Forecast, 2005-2011

Exhibit ES-5:   Prescription Analgesics/Anesthetics, Market Forecast, 2005-2011

Exhibit ES-6:   Pain Management Devices, Market Forecast, 2005-2011

 

1. PAIN MANAGEMENT OVERVIEW

1.1 Pain Physiology

1.1.1 The Nervous System

1.1.2 Pain Perception

1.1.3 Pain Classification

1.1.3.1 Nociceptive Pain

1.1.3.2 Neuropathic Pain

1.1.3.3 Acute Pain

1.1.3.4 Chronic Pain

1.2 Pain Assessment Techniques

1.3 Pain Prevalence

1.4 Common Pain Syndromes

1.4.1 Arthritis Pain

1.4.2 Back Pain

1.4.3 Burn Pain

1.4.4 Cancer Pain

1.4.5 Headache Pain

1.4.6 Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Pain

1.4.7 Obstetric Pain

1.4.8 Temporomandibular Pain

1.4.9 Trauma Pain

1.5 Clinical Approaches to Pain Management

1.5.1 Pain Management Guidelines

1.5.2 Pain Management Options

1.5.2.1 Pharmaceutical Options

1.5.2.2 Device-Based Options

1.5.2.3 Alternative-Therapy Options

 

Exhibit 1-1:       Common Causes of Neuropathic Pain

Exhibit 1-2:       United States Population, by Selected Ages, 1990-2050

Exhibit 1-3:       Overview of the Joint Commission on Accreditation of Healthcare Organizations' Standards for Pain Assessment and Management

 

2. GENERAL ISSUES IN PAIN MANAGEMENT

2.1 Regulatory and Legal Issues in Pain Management

2.1.1 Joint Commission on Accreditation of Healthcare Organizations Guidelines

2.1.2 Barriers to Effective Pain Management

2.1.3 State Regulators Ease Rules on Pain Medication

2.2 Misconceptions Associated with End-of-Life Pain Management

2.3 Pain Management Trends

 

3. PAIN MANAGEMENT PHARMACEUTICALS

3.1 Pharmaceutical Formulations and Drug Delivery

3.1.1 Oral Drug Delivery

3.1.2 Injection/Infusion Drug Delivery

3.1.2.1 Injection

3.1.2.1.1 Intramuscular Injection

3.1.2.1.2 Subcutaneous Injection

3.1.2.2 Infusion

3.1.2.2.1 Intravenous Infusion

3.1.2.2.2 Intraspinal Infusion

3.1.2.2.3 Intraoperative Site Infusion

3.1.3 Inhalation Drug Delivery

3.1.4 Transdermal Drug Delivery

3.1.5 Transmucosal Drug Delivery

3.1.6 Nonsteroidal Anti-Inflammatory Drugs

3.1.6.1 Heart Attack and Hypertension Risks

3.1.6.2 Food and Drug Administration and Labeling

3.1.6.3 Other Risks

3.2 Aspirin Benefits

3.2.1 Aspirin and Heart Attack Prevention

3.2.2 Aspirin and Heart Attack Prevention in Women

3.2.3 Aspirin and Bedtime Blood Pressure

3.2.4 Aspirin and Heart Failure Patients

3.2.5 Aspirin and Atherothrombosis

3.2.6 Aspirin and Cancer Prevention

3.3 The Pain Management Pharmaceuticals Market

3.3.1 Nonprescription Analgesics/Anesthetics

3.3.1.1 Market Forecast

3.3.1.2 Nonprescription Systemic Analgesics

3.3.1.2.1 Acetaminophen

3.3.1.2.2 Nonprescription Nonsteroidal Anti-Inflammatory Drugs

3.3.1.2.2.1 Aspirin

3.3.1.2.2.2 Ibuprofen

3.3.1.2.2.3 Ketoprofen

3.3.1.2.2.4 Naproxen

3.3.1.2.3 Market Forecast

3.3.1.2.4 Competitive Analysis

3.3.1.3 Nonprescription Topical Analgesics/Anesthetics

3.3.1.3.1 Amino Amides and Esters

3.3.1.3.2 Capsaicin

3.3.1.3.3 Methyl and Trolamine Salicylates

3.3.1.3.4 Topical Patches

3.3.1.3.5 Topical Pain Relieving Formulations and Applications

3.3.1.3.6 Market Forecast

3.3.1.3.7 Competitive Analysis

3.3.2 Prescription Analgesics/Anesthetics

3.3.2.1 Prescription Analgesics/Anesthetics Market Forecast

3.3.2.2 Prescription Nonsteroidal Anti-Inflammatory Drugs

3.3.2.2.1 Acetic Acid Derivatives

3.3.2.2.2 Anthranilic Acid Derivatives

3.3.2.2.3 Cyclooxygenase-2 Selective Inhibitors

3.3.2.2.4 Enolic Acid Derivatives

3.3.2.2.5 Propionic Acid Derivatives

3.3.2.2.6 Salicylic Acid Derivatives

3.3.2.2.7 Black Box Warnings for Nonsteroidal Anti-Inflammatory Drugs and Cyclooxygenase-2 Inhibitors

3.3.2.2.8 Market Forecast

3.3.2.2.9 Competitive Analysis

3.3.2.3 Opioid Analgesics

3.3.2.3.1 Buprenorphine

3.3.2.3.2 Butorphanol

3.3.2.3.3 Codeine

3.3.2.3.4 Fentanyl

3.3.2.3.5 Hydromorphone

3.3.2.3.6 Levorphanol

3.3.2.3.7 Meperidine

3.3.2.3.8 Morphine

3.3.2.3.9 Nalbuphine

3.3.2.3.10 Oxycodone

3.3.2.3.11 Oxymorphone

3.3.2.3.12 Pentazocine

3.3.2.3.13 Propoxyphene

3.3.2.3.14 Remifentanil

3.3.2.3.15 Tramadol

3.3.2.3.16 Market Forecast

3.3.2.3.17 Competitive Analysis

3.3.2.4 Opioid/Nonopioid Combination Analgesics

3.3.2.4.1 Market Forecast

3.3.2.5 Antimigraine Analgesics

3.3.2.5.1 Dihydroergotamine

3.3.2.5.2 Triptans

3.3.2.5.3 Divalproex Sodium

3.3.2.5.4 Market Forecast

3.3.2.5.5 Competitive Analysis

3.3.2.6 Adjuvant Analgesics

3.3.2.6.1 Anticonvulsants

3.3.2.6.2 Antidepressants

3.3.2.6.3 Corticosteroids

3.3.2.6.4 Market Forecast

3.3.2.6.5 Competitive Analysis

3.3.2.7 General, Regional, and Local Anesthetics

3.3.2.7.1 Inhalation General Anesthetics

3.3.2.7.2 Intravenous General Anesthetics

3.3.2.7.3 Anesthetics Used in Balanced Anesthesia

3.3.2.7.4 Regional/Local Anesthetics

3.3.2.7.5 Market Forecast

3.3.2.7.6 Competitive Analysis

3.3.2.8 Conotoxins

3.3.3 Combined Market Forecast

3.4 Pain Management Pharmaceuticals in Development

 

Exhibit 3-1:       Advantages and Disadvantages of Common Drug Delivery Methods

Exhibit 3-2:       2006, Selected Nonprescription Analgesics/Anesthetics

Exhibit 3-3:       2006, Selected Prescription Analgesics/Anesthetics

Exhibit 3-4:       Nonprescription Analgesics/Anesthetics, Market Forecast, 2005-2011

Exhibit 3-5:       2006, Selected Nonprescription Systemic Analgesics

Exhibit 3-6:       Nonprescription Systemic Analgesics, Market Forecast, 2005-2011

Exhibit 3-7:       2005, Nonprescription Systemic Analgesics Market, Share by Supplier

Exhibit 3-8:       2006, Selected Nonprescription Topical Analgesics/Anesthetics

Exhibit 3-9:       2006, Selected Nonprescription Topical Analgesic Patches

Exhibit 3-10:   Nonprescription Topical Analgesics, Market Forecast, 2005-2011

Exhibit 3-11:   2005, Nonprescription Topical Analgesics/Anesthetics Market, Share by Supplier

Exhibit 3-12:   Prescription Analgesics/Anesthetics, Market Forecast, 2005-2011

Exhibit 3-13:   2006, Selected Prescription Nonsteroidal Anti-Inflammatory Drugs

Exhibit 3-14:   Prescription Nonsteroidal Anti-Inflammatory Drugs, Market Forecast, 2005-2011

Exhibit 3-15:   2005, Prescription Nonsteroidal Anti-Inflammatory Drugs Market, Share by Supplier

Exhibit 3-16:   2006, Selected Prescription Opioid Analgesics

Exhibit 3-17:   Prescription Opioid Analgesics, Market Forecast, 2005-2011

Exhibit 3-18:   2005, Prescription Opioid Analgesics Market, Share by Supplier

Exhibit 3-19:   2006, Selected Prescription Opioid/Nonopioid Combination Analgesics

Exhibit 3-20:   Prescription Opioid/Nonopioid Combination Analgesics, Market Forecast, 2005-2011

Exhibit 3-21:   2006, Selected Prescription Antimigraine Analgesics

Exhibit 3-22:   Prescription Antimigraine Analgesics, Market Forecast, 2005-2011

Exhibit 3-23:   2005, Prescription Antimigraine Analgesics Market, Share by Supplier

Exhibit 3-24:   2006, Selected Prescription Adjuvant Analgesics

Exhibit 3-25:   Prescription Adjuvant Analgesics, Market Forecast, 2005-2011

Exhibit 3-26:   2005, Prescription Adjuvant Analgesics Market, Share by Supplier

Exhibit 3-27:   2006, Selected General Anesthetics

Exhibit 3-28:   2006, Selected Regional/Local Anesthetics

Exhibit 3-29:   General, Regional, and Local Anesthetics, Market Forecast, 2005-2011

Exhibit 3-30:   2005, General, Regional, and Local Anesthetics Market, Share by Supplier

Exhibit 3-31:   Pain Management Pharmaceuticals, Combined Market Forecast, 2005-2011

Exhibit 3-32:   2006, Selected Pain Management Pharmaceuticals in Development

 

4. PAIN MANAGEMENT DEVICES

4.1 Electrical Stimulators

4.1.1 Transcutaneous Electrical Nerve Stimulators

4.1.1.1 Products and Competitors

4.1.1.1.1 American Imex

4.1.1.1.2 BioMedical Life Systems

4.1.1.1.3 Compex Technologies/Encore Medical

4.1.1.1.4 Dynatronics

4.1.1.1.5 Empi/Encore Medical

4.1.1.1.6 RS Medical

4.1.1.2 Market Forecast

4.1.1.3 Competitive Analysis

4.1.2 Neurostimulators

4.1.2.1 Neuromuscular Stimulators

4.1.2.2 Spinal Cord Stimulators

4.1.2.3 Products and Competitors

4.1.2.3.1 Advanced Neuromodulation Systems/St. Jude Medical

4.1.2.3.2 Advanced Bionics/Guidant

4.1.2.3.3 Compex Technologies/Encore Medical

4.1.2.3.4 Empi/Encore Medical

4.1.2.3.5 Medtronic

4.1.2.3.6 Mettler Electronics

4.1.2.3.7 Prizm Medical

4.1.2.3.8 Rich-Mar

4.1.2.3.9 RS Medical

4.1.2.4 Market Forecast

4.1.2.5 Competitive Analysis

4.2 Analgesia Infusion Pumps

4.2.1 Implantable Analgesia Infusion Pumps

4.2.1.1 Products and Competitors

4.2.1.1.1 Codman & Shurtleff/Johnson & Johnson

4.2.1.1.2 Medtronic

4.2.1.2 Market Forecast

4.2.1.3 Competitive Analysis

4.2.2 External Analgesia Infusion Pumps

4.2.2.1 Nerve Block

4.2.2.2 Patient-Controlled Analgesia Infusion Pumps

4.2.2.3 Products and Competitors

4.2.2.3.1 Baxter Healthcare/Baxter International

4.2.2.3.2 Curlin Medical

4.2.2.3.3 Hospira

4.2.2.3.4 I-Flow

4.2.2.3.5 MarCal Medical

4.2.2.3.6 McKinley Medical

4.2.2.3.7 Medex/Smiths Group

4.2.2.3.8 Smiths Medical MD/Smiths Group

4.2.2.3.9 Stryker

4.2.2.4 Market Forecast

4.2.2.5 Competitive Analysis

4.3 Market Forecast

 

Exhibit 4-1:       Proposed Fourth Step of the World Health Organization Analgesic Ladder

Exhibit 4-2:       2006, Selected Painful Medical Conditions That May Be Treated Using Electrical Stimulation

Exhibit 4-3:       2006, Selected Transcutaneous Electrical Nerve Stimulators

Exhibit 4-4:       Transcutaneous Electrical Nerve Stimulators, Market Forecast, 2005-2011

Exhibit 4-5:       2005, Transcutaneous Electrical Nerve Stimulators Market, Share by Supplier

Exhibit 4-6:       2006, Selected Neurostimulators

Exhibit 4-7:       Neurostimulators, Market Forecast, 2005-2011

Exhibit 4-8:       2005, Spinal Cord Stimulators Market, Share by Supplier

Exhibit 4-9:       2005, Neuromuscular Stimulators Market, Share by Supplier

Exhibit 4-10:   2006, Selected Implantable Analgesia Infusion Pumps

Exhibit 4-11:   Implantable Analgesia Infusion Pumps, Market Forecast, 2005-2011

Exhibit 4-12:   2005, Implantable Analgesia Infusion Pumps Market, Share by Supplier

Exhibit 4-13:   2006, Selected External Analgesia Infusion Pumps

Exhibit 4-14:   External Analgesia Infusion Pumps, Market Forecast, 2005-2011

Exhibit 4-15:   2005, External Analgesia Infusion Pumps Market, Share by Supplier

Exhibit 4-16:   Pain Management Devices, Market Forecast, 2005-2011

 

5. PAIN MANAGEMENT SERVICES

5.1 Pain Management Services in the United States

5.1.1 Home Care

5.1.2 Hospice Care

5.2 Pain Management Centers and Clinics

5.2.1 Types of Pain Management Facilities

5.2.2 A Multidisciplinary Pain Center Approach

5.2.3 Pain Management Program Selection

5.2.3.1 The Blaustein Pain Treatment Center

5.2.3.2 The Cleveland Pain Clinic

5.2.3.3 The Norman Marcus Pain Institute

5.2.3.4 The Mensana Clinic

5.2.3.5 The Pain & Rehabilitation Clinic of Chicago

5.2.3.6 The Rosomoff Comprehensive Pain Center

5.2.3.7 The Multidisciplinary Pain Center at the University of Washington Medical Center

 

Exhibit 5-1:       Harmful Effects of Physiological Stress Caused by Chronic Pain

Exhibit 5-2:       Pain Management Facilities Classification

 

6. COMPLEMENTARY AND ALTERNATIVE MEDICINE TECHNIQUES IN PAIN MANAGEMENT

6.1 The Complementary and Alternative Medicine Market

6.2 The National Center for Complementary and Alternative Medicine

6.3 Healthcare Providers and Complementary and Alternative Medicine

6.4 Complementary and Alternative Medicine Pain Management Therapies

6.4.1 Acupuncture

6.4.2 Biofeedback

6.4.3 Chiropractic

6.4.4 Cognitive-Behavioral Therapy

6.4.5 Hypnosis

6.4.6 Massage Therapy

6.4.7 Meditation

6.4.8 Medical Marijuana

6.4.8.1 Smoking Cannabis for Pain Relief

6.4.8.2 Synthetic Cannabinoids

 

Exhibit 6-1:       Regional Popularity of Alternative Medicine Treatments in the United States

Exhibit 6-2:       Complementary and Alternative Medicine Growth in the United States, 1930s-1990s

Exhibit 6-3:       2000, Types of Complementary and Alternative Medicine Practitioners Visited by People in the United States

Exhibit 6-4:       2000, Reasons Cited for Visiting Alternative Medicine Practitioners

 

7. COMPANY PROFILES

7.1     Abbott Laboratories

7.2     Advanced Neuromodulation Systems, Inc./St. Jude Medical, Inc.

7.3     Corgentech, Inc.

7.4     AstraZeneca PLC

7.5     Baxter Healthcare Corporation/Baxter International, Inc.

7.6     Bayer HealthCare AG/Bayer AG

7.7     Boehringer Ingelheim GmbH

7.8     Bristol-Myers Squibb Company

7.9     Chattem, Inc.

7.10 Encore Medical Corporation

7.11 Endo Pharmaceuticals, Inc./Endo Pharmaceuticals Holdings, Inc.

7.12 GlaxoSmithKline PLC

7.13 I-Flow Corporation

7.14 International Rehabilitative Sciences, Inc., dba RS Medical

7.15 Johnson & Johnson

7.16 Eli Lilly and Company

7.17 Medtronic, Inc.

7.18 Merck & Company, Inc.

7.19 Novartis AG

7.20 Pfizer, Inc.

7.21 Purdue Pharma LP

7.22 Roche Pharmaceuticals, Inc./F. Hoffmann-La Roche LTD

7.23 Smiths Medical MD, Inc./Smiths Group PLC

7.24 Stryker Corporation

7.25 Wyeth



COMPANIES COVERED:

  1. Abbott Laboratories
  2. Advanced Neuromodulation Systems, Inc./St. Jude Medical, Inc.
  3. Corgentech, Inc.
  4. AstraZeneca PLC
  5. Baxter Healthcare Corporation/Baxter International, Inc.
  6. Bayer HealthCare AG/Bayer AG
  7. Boehringer Ingelheim GmbH
  8. Bristol-Myers Squibb Company
  9. Chattem, Inc.
  10. Encore Medical Corporation
  11. Endo Pharmaceuticals, Inc./Endo Pharmaceuticals Holdings, Inc.
  12. I-Flow Corporation
  13. International Rehabilitative Sciences, Inc., dba RS Medical
  14. Johnson & Johnson
  15. Eli Lilly and Company
  16. Medtronic, Inc.
  17. Merck & Company, Inc.
  18. Novartis AG
  19. Pfizer, Inc.
  20. Purdue Pharma LP
  21. Roche Pharmaceuticals, Inc./F. Hoffmann-La Roche LTD
  22. Smiths Medical MD, Inc./Smiths Group PLC
  23. Stryker Corporation
  24. Wyeth
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