U.S. MARKETS FOR PHARMACOLOGIC AND DEVICE-BASED THERAPEUTIC APPROACHES TO PAIN MANAGEMENT

268 Pages | 62 Exhibits | 2011 Analysis | Forecasts Through 2014 Product Family: Market Reports




OVERVIEW:
Pain is the single most common reason patients seek medical care, accounting for approximately half of all physician office visits in the U.S. The estimated economic impact of pain in the U.S., including disability and lost productivity costs, totals approximately $100 billion annually. In 2010, combined U.S. sales of pain management products (pharmaceuticals and devices) totaled approximately $33.1 billion. Over the forecast period covered by this report, total sales of pain management products are expected to increase at a compound annual rate of 3.7%, reaching approximately $38.2 billion in the year 2014.

This new report by Medtech Insight includes analyses of products, technologies, current and forecast markets, competitors, and opportunities in the U.S. pain management products market. Major topics covered by this report include an overview of the physiology of pain, regulatory and legal issues in pain management, pain management pharmaceuticals (including nonprescription systemic analgesics [acetaminophen, aspirin, ibuprofen, ketoprofen, and naproxen], nonprescription topical analgesics/anesthetics, prescription nonsteroidal anti-inflammatory drugs [or NSAIDs], opioid analgesics, opioid/nonopioid analgesics, prescription antimigraine analgesics, prescription adjuvant analgesics, and anesthetics [general, regional, and local]); pain management devices (including transcutaneous electrical nerve stimulation [or TENS] devices, neurostimulators, and implantable and external analgesia infusion pumps); pain management services such as home care and hospice care; and complementary and alternative medicine (or CAM) techniques in pain management (including acupuncture, biofeedback, chiropractic, energy therapy, homeopathy, cognitive-behavioral therapy, hypnosis, massage therapy, meditation, and medical marijuana).

TABLE OF CONTENTS:
EXECUTIVE SUMMARY

i. Pain Management Pharmaceuticals 
	a. Nonprescription Analgesics/Anesthetics 
		i. Nonprescription Systemic Analgesics 
		ii. Nonprescription Topical Analgesics/Anesthetics 
		iii. Nonprescription Analgesics/Anesthetics, Market Forecast 
	b. Prescription Analgesics/Anesthetics 
		i. Prescription Nonsteroidal Anti-Inflammatory Drugs 
		ii. Prescription Opioid Analgesics 
		iii. Prescription Opioid/Nonopioid Combination Analgesics 
		iv. Prescription Antimigraine Analgesics 
		v. Prescription Adjuvant Analgesics 
		vi. Prescription General, Regional, and Local Anesthetics 
		vii. Prescription Analgesics/Anesthetics, Market Forecast 
	c. Pain Management Pharmaceuticals, Market Forecast 
ii. Pain Management Devices 
	a. Electrical Stimulators 
		i. Transcutaneous Electrical Nerve Stimulators
		ii. Neurostimulators 
	b. Analgesia Infusion Pumps 
		i. Implantable Analgesia Infusion Pumps 
		ii. External Analgesia Infusion Pumps 
	c. Pain Management Devices, Market Forecast 
iii. Pain Management Services 
	a. Home Care 
	b. Hospice Care 
	c. Pain Management Centers and Clinics 
iv. Complementary and Alternative Medicine Techniques for Pain Management 
	a. Acupuncture 
	b. Biofeedback 
	c. Chiropractic 
	d. Energy Therapy 
	e. Homeopathy 
	f. Cognitive-Behavioral Therapy 
	g. Hypnosis 
	h. Massage Therapy 
	i. Meditation 
	j. Medical Marijuana 
v. Combined Market Forecast 

Exhibit ES-1: United States Population, by Selected Ages, 1990-2050 
Exhibit ES-2: Overview of the Joint Commission's Standards for Pain Assessment and Management 
Exhibit ES-3: Pain Management Pharmaceuticals, Market Forecast, 2010-2014 
Exhibit ES-4: Pain Management Devices, Market Forecast, 2010-2014 
Exhibit ES-5: Pain Management Pharmaceuticals and Devices, Combined Market Forecast, 2010-2014 

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 Non-Nociceptive 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 Podiatric Pain 
	1.4.9 Sciatic Pain 
	1.4.10 Temporomandibular Pain 
	1.4.11 Trauma Pain 
1.5 Clinical Approaches to Pain Management 
	1.5.1 Pain Management Guidelines 
	1.5.2 Pain Management Guidelines for Older Adults 
	1.5.3 Interventional Pain Management Guidelines 
	1.5.4 Pain Management Options 
		1.5.4.1 Pharmaceutical Options 
		1.5.4.2 Device-Based Options 
		1.5.4.3 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's Standards for Pain Assessment and Management 

2. GENERAL ISSUES IN PAIN MANAGEMENT

2.1 Regulatory and Legal Issues in Pain Management 
	2.1.1 National Pain Care Policy Act of 2009 
	2.1.2 Drug Enforcement Administration Guidelines for Dispensing Controlled Substances 
	2.1.3 Joint Commission Guidelines 
	2.1.4 Barriers to Effective Pain Management 
	2.1.5 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 The Food and Drug Administration and Labeling 
		3.1.6.3 Naproxen Risks 
3.2 The Benefits of Aspirin 
	3.2.1 Aspirin and Heart Attack/Stroke Prevention 
	3.2.2 Aspirin and Heart Failure 
	3.2.3 Aspirin and Cancer Prevention 
3.3 Market Analysis 
	3.3.1 Nonprescription Analgesics and 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 and 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 Market Forecast 
			3.3.1.3.6 Competitive Analysis 
	3.3.2 Prescription Analgesics and Anesthetics 
		3.3.2.1 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 Market Forecast 
			3.3.2.2.8 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 Tapentadol 
			3.3.2.3.17 Market Forecast 
			3.3.2.3.18 Competitive Analysis 
		3.3.2.4 Opioid/Nonopioid Combination Analgesics 
			3.3.2.4.1 Market Forecast 
			3.3.2.4.2 Competitive Analysis 
		3.3.2.5 Antimigraine Analgesics 
			3.3.2.5.1 Diclofenac 
			3.3.2.5.2 Dihydroergotamine 
			3.3.2.5.3 Divalproex Sodium 
			3.3.2.5.4 Triptans 
			3.3.2.5.5 Market Forecast 
			3.3.2.5.6 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 Corticosteriods 
			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 
	3.3.3 Combined Market Forecast 

Exhibit 3-1: Advantages and Disadvantages of Common Drug Delivery Methods 
Exhibit 3-2: 2011, Selected Nonprescription Analgesics and Anesthetics 
Exhibit 3-3: 2011, Selected Prescription Analgesics and Anesthetics 
Exhibit 3-4: Nonprescription Analgesics and Anesthetics,  Market Forecast, 2010-2014 
Exhibit 3-5: 2011, Selected Nonprescription Systemic Analgesics 
Exhibit 3-6: Nonprescription Systemic Analgesics, Market Forecast, 2010-2014 
Exhibit 3-7: 2010, Nonprescription Systemic Analgesics Market,  Share by Supplier 
Exhibit 3-8: 2011, Selected Nonprescription Topical Analgesics/Anesthetics 
Exhibit 3-9: 2011, Selected Nonprescription Topical Analgesic Patches 
Exhibit 3-10: Nonprescription Topical Analgesics/Anesthetics,  Market Forecast, 2010-2014 
Exhibit 3-11: 2010, Nonprescription Topical Analgesics/Anesthetics Market, Share by Supplier 
Exhibit 3-12: Prescription Analgesics and Anesthetics, Market Forecast, 2010-2014 
Exhibit 3-13: 2011, Selected Prescription Nonsteroidal  Anti-Inflammatory Drugs 
Exhibit 3-14: Prescription Nonsteroidal Anti-Inflammatory Drugs,  Market Forecast, 2010-2014 
Exhibit 3-15: 2010, Prescription Nonsteroidal Anti-Inflammatory  Drugs Market, Share by Supplier 
Exhibit 3-16: 2011, Selected Prescription Opioid Analgesics 
Exhibit 3-17: Prescription Opioid Analgesics, Market Forecast, 2010-2014 
Exhibit 3-18: 2010, Prescription Opioid Analgesics Market, Share by Supplier 
Exhibit 3-19: 2011, Selected Prescription Opioid/Nonopioid  Combination Analgesics 
Exhibit 3-20: Prescription Opioid/Nonopioid Combination Analgesics,  Market Forecast, 2010-2014 
Exhibit 3-21: 2011, Selected Prescription Antimigraine Analgesics 
Exhibit 3-22: Prescription Antimigraine Analgesics,  Market Forecast, 2010-2014 
Exhibit 3-23: 2010, Prescription Antimigraine Analgesics Market,  Share by Supplier 
Exhibit 3-24: 2011, Selected Prescription Adjuvant Analgesics 
Exhibit 3-25: Prescription Adjuvant Analgesics, Market Forecast, 2010-2014 
Exhibit 3-26: 2010, Prescription Adjuvant Analgesics Market,  Share by Supplier 
Exhibit 3-27: 2011, Selected General Anesthetics 
Exhibit 3-28: 2011, Selected Regional/Local Anesthetics 
Exhibit 3-29: General, Regional, and Local Anesthetics,  Market Forecast, 2010-2014 
Exhibit 3-30: 2010, General, Regional, and Local Anesthetics Market,  Share by Supplier 
Exhibit 3-31: Pain Management Pharmaceuticals, Combined Market Forecast, 2010-2014 

4. PAIN MANAGEMENT DEVICES

4.1 Electrical Stimulators 
	4.1.1 Transcutaneous Electrical Nerve Stimulators 
		4.1.1.1 Products 
		4.1.1.2 Market Forecast 
		4.1.1.3 Competitive Analysis 
	4.1.2 Neurostimulators 
		4.1.2.1 Occipital Nerve Stimulation 
		4.1.2.2 Neuromuscular Stimulators 
		4.1.2.3 Spinal Cord and Peripheral Nerve Stimulators 
		4.1.2.4 Products 
		4.1.2.5 Market Forecast 
		4.1.2.6 Competitive Analysis 
4.2 Analgesia Infusion Pumps 
	4.2.1 Implantable Analgesia Infusion Pumps 
		4.2.1.1 Products 
		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 
		4.2.2.4 Market Forecast 
		4.2.2.5 Competitive Analysis 
4.3 Combined Market Forecast 
4.4 Innovations in Pain Management Devices 

Exhibit 4-1: Proposed Fourth Step of the World Health Organization Analgesic Ladder 
Exhibit 4-2: Selected Painful Conditions Appropriate for Electrical Stimulation Therapy 
Exhibit 4-3: 2011, Selected Transcutaneous Electrical Nerve Stimulators 
Exhibit 4-4: Transcutaneous Electrical Nerve Stimulators,  Market Forecast, 2010-2014 
Exhibit 4-5: 2010, Transcutaneous Electrical Nerve Stimulators Market, Share by Supplier 
Exhibit 4-6: 2011, Selected Neurostimulators 
Exhibit 4-7: Neurostimulators, Market Forecast, 2010-2014 
Exhibit 4-8: 2010, Spinal Cord/Peripheral Nerve Stimulators Market,  Share by Supplier 
Exhibit 4-9: 2010, Neuromuscular Stimulators Market, Share by Supplier 
Exhibit 4-10: 2011, Selected Implantable Analgesia Infusion Pumps 
Exhibit 4-11: Implantable Analgesia Infusion Pumps,  Market Forecast, 2010-2014 
Exhibit 4-12: 2010, Implantable Analgesia Infusion Pumps Market,  Share by Supplier 
Exhibit 4-13: 2011, Selected External Analgesia Infusion Pumps 
Exhibit 4-14: External Analgesia Infusion Pumps, Market Forecast, 2010-2014 
Exhibit 4-15: 2010, External Analgesia Infusion Pumps Market,  Share by Supplier 
Exhibit 4-16: Pain Management Devices, Combined Market Forecast, 2010-2014 

5. PAIN MANAGEMENT SERVICES

5.1 Pain Management Services 
	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 Rosomoff Comprehensive Pain Center 
		5.2.3.6 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: World Health Organization's Pain Relief Ladder 
Exhibit 5-3: Pain Management Facilities Classification 

6. COMPLEMENTARY AND ALTERNATIVE MEDICINE TECHNIQUES IN PAIN MANAGEMENT

6.1 The Complementary and Alternative Medicine Services 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 Energy Therapy 
	6.4.5 Homeopathy 
	6.4.6 Cognitive-Behavioral Therapy 
	6.4.7 Hypnosis 
	6.4.8 Massage Therapy 
	6.4.9 Meditation 
	6.4.10 Medical Marijuana 
		6.4.10.1 Smoking Cannabis for Pain Relief 
		6.4.10.2 Synthetic Cannabinoids 

Exhibit 6-1: Rate of Complementary and Alternative Medicine Use Among Patients with Selected Chronic Conditions 
Exhibit 6-2: Regional Demand for Complementary and Alternative Medicine 
Exhibit 6-3: Use of Complementary and Alternative Medicine, 1930s-1990s 
Exhibit 6-4: Complementary and Alternative Medicine Therapy, Historic Incidence, 2002 and 2007 

7. COMPANY PROFILES

7.1 Abbott Laboratories 
7.2 Baxter Healthcare Corporation/Baxter International, Inc. 
7.3 Bayer HealthCare AG/Bayer AG 
7.4 Boston Scientific Corporation 
7.5 Cephalon, Inc. 
7.6 Chattem, Inc./sanofi-aventis 
7.7 Empi, Inc./DJO LLC 
7.8 Endo Pharmaceuticals Holdings, Inc. 
7.9 GlaxoSmithKline PLC 
7.10 Hospira, Inc. 
7.11 Johnson & Johnson 
7.12 Eli Lilly and Company 
7.13 Medtronic, Inc. 
7.14 Pfizer, Inc. 
7.15 Purdue Pharma LP 

APPENDIX:  COMPANY LISTING


COMPANIES COVERED:

  1. Abbott Laboratories
  2. Baxter Healthcare Corporation/Baxter International, Inc.
  3. Bayer HealthCare AG/Bayer AG
  4. Boston Scientific Corporation
  5. Cephalon, Inc.
  6. Chattem, Inc./sanofi-aventis
  7. Empi, Inc./DJO LLC
  8. Endo Pharmaceuticals Holdings, Inc.
  9. GlaxoSmithKline PLC
  10. Hospira, Inc.
  11. Johnson & Johnson
  12. Eli Lilly and Company
  13. Medtronic, Inc.
  14. Pfizer, Inc.
  15. Purdue Pharma LP
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