The Global Market for Pain Management Drugs and Devices

Table of Contents

Chapter- 1: INTRODUCTION -- Complimentary 3

• STUDY GOALS AND OBJECTIVES 1
• REASONS FOR DOING THE STUDY 1
• SCOPE OF REPORT 1
• METHODOLOGY 2
• ANALYST CREDENTIALS 2
• RELATED BCC STUDIES 2
• BCC RESEARCH ONLINE SERVICES 3
• DISCLAIMER 3

Chapter-2: SUMMARY 2

• HISTORY OF PAIN AND PAIN TREATMENT 6
• THE PERCEPTION OF PAIN 7
• Types of Pain 8
• Acute Pain 8
• Chronic Pain 8
• ASSESSMENT OF PAIN 9
• Subjective 9
• Objective 9
• TABLE 1 OBJECTIVE SIGNS OF PAIN 10
• HOW PAIN IS DIAGNOSED 10
• THERMOGRAPHY 11
• HOW PAIN IS TREATED 11
• FIGURE 1 PAIN-MANAGEMENT TECHNIQUES 11
• HOW PAIN IS TREATED (CONTINUED) 12
• HOW PAIN IS TREATED (CONTINUED) 13
• HOW PAIN IS TREATED (CONTINUED) 14
• HOW PAIN IS TREATED (CONTINUED) 15
• HOW PAIN IS TREATED (CONTINUED) 16
• HOW PAIN IS TREATED (CONTINUED) 17
• THE AGING U.S. POPULATION 18
• TABLE 2 U.S. POPULATION ESTIMATES BY AGE GROUP AND GENDER, 1950 AND 2000 (MILLIONS) 18
• FIGURE 2 U.S. POPULATION ESTIMATES, BY AGE GROUP, 1950 AND 2000 (MILLIONS) 19
• FIGURE 3 U.S. POPULATION ESTIMATES BY GENDER, 1950 AND 2000 (MILLIONS) 19
• TABLE 3 U.S. POPULATION PROJECTIONS BY AGE GROUP AND GENDER FOR SPECIFIC YEARS, 2010-2050 (MILLIONS) 20
• FIGURE 4 U.S. POPULATION PROJECTIONS, BY SELECTED AGE GROUP FOR SPECIFIC YEARS, 2010-2050 (MILLIONS) 20
• FIGURE 5 U.S. POPULATION PROJECTIONS, BY GENDER FOR SPECIFIC YEARS, 2010-2050 (MILLIONS) 21
• WORLD DEMOGRAPHICS 21
• TABLE 4 WORLD POPULATION GROWTH BY GEOGRAPHICAL REGION, 2008 AND 2013 (MILLIONS) 21
• TABLE 4 (CONTINUED) 22
• FIGURE 6 WORLD POPULATION BY GEOGRAPHICAL REGION, 2008 AND 2013 (MILLIONS) 22
• TABLE 5 ESTIMATED AND PROJECTED WORLD POPULATION BY AGE AND GENDER, 2008 AND 2013 23
• FIGURE 7 ESTIMATED AND PROJECTED WORLD POPULATION BY AGE AND GENDER, 2008 AND 2013 (MILLIONS) 23
• LIFE EXPECTANCY FOR MEN AND WOMEN 23
• TABLE 6 CURRENT AND PROJECTED U.S. LIFE EXPECTANCY AT BIRTH BY GENDER AND YEAR, 2000-2020 (YEARS) 24
• FIGURE 8 CURRENT AND PROJECTED U.S. LIFE EXPECTANCY AT BIRTH BY GENDER AND YEAR, 2000-2020 (YEARS) 24
• INCIDENCE OF PAIN 25
• PREVALENCE OF PAIN 25
• Severe Headache or Migraine, Low Back, and Neck Pain 25
• TABLE 7 SEVERE HEADACHE OR MIGRAINE, LOW BACK PAIN, AND NECK PAIN AMONG ADULTS, 18 YEARS OF AGE AND OVER*, 1997-2009 (%) 26
• FIGURE 9 SEVERE HEADACHE OR MIGRAINE, LOW BACK PAIN, AND NECK PAIN AMONG ADULTS, 18 YEARS OF AGE AND OVER*, 1997-2009 (%) 26
• Joint Pain 27
• TABLE 8 JOINT PAIN AMONG ADULTS 18 YEARS OF AGE AND OVER*, 2002-2009 (%) 27
• FIGURE 10 JOINT PAIN AMONG ADULTS 18 YEARS OF AGE AND OVER*, 2002-2009 (%) 28
• Cancer Pain 28
• Cancer Pain (Continued) 29
• FIGURE 11 CAUSES OF CANCER PAIN 30
• Pain Management in Cancer 30
• TABLE 9 CANCER PAIN MEDICATION 31
• Description of Some of Key Medications for Cancer Pain Control 31
  • Morphine 31
  • Fentanyl 32
  • Hydromorphone 32
  • Methadone 32
  • Buprenorphine 33
  • Oxycodone 33
  • Diamorphine 33
• HIV/AIDS Related Pain 33
• TABLE 10 ESTIMATED HIV REPORTED CASES BY SELECTED CHARACTERISTICS, 2007 34
• FIGURE 12 ESTIMATED HIV REPORTED CASES BY AGE GROUP, 2007 34
• FIGURE 13 ESTIMATED HIV REPORTED CASES BY GENDER, 2007 35
• FIGURE 14 ESTIMATED HIV REPORTED CASES BY RACE, 2007 35
• Burn Pain 35
• Burn Classifications 36
• TABLE 11 BURN CLASSIFICATIONS 36
• Stages of Burn Healing 37
• Stages of ... (Continued) 38
• Challenges Associated with Burn Pain 39
• Burn Pain Management 39
• FIGURE 15 BURN PAIN MANAGEMENT APPROACH 40
• Dental Pain 40
• Treatment for Dental Pain 41
• GENDER AND PAIN 41
• TABLE 12 PAIN BY SELECTED CATEGORY AND GENDER IN THE 18+ U.S. POPULATION*, 1997-2006 (%) 42
• FIGURE 16 PAIN BY SELECTED CATEGORY AND GENDER IN THE 18+ U.S. POPULATION*, 1997-2006 (%) 43
• OTHER INFLUENCES DETERMINING HOW PAIN IS FELT AMONG INDIVIDUALS 43
• Objective Pain Measurement 44
• OBSTETRICS PAIN 44
• ORTHOPEDIC PAIN 44
• PEDIATRIC PAIN 44
• Pediatric Pain (Continued) 45
• SURGICAL PAIN 46
• GLOBAL PAIN MANAGEMENT 47

Chapter-3: INDUSTRY OVERVIEW 42

Chapter-4: INDUSTRY TRENDS 35

• PHARMACEUTICAL PAIN MANAGEMENT 83
• PRESCRIPTION PAIN MANAGEMENT PRODUCTS 83
• Analgesic Drugs 83
• Non-Narcotic 84
• Narcotic 84
• Narcotic (Continued) 85
• Narcotic (Continued) 86
• Full and Partial Agonists 87
• Agonist-Antagonists 88
• Nonsteroid Anti-inflammatory Drugs 89
• Anti-migraine Drugs 90
• Anti-migraine Drugs (Continued) 91
• TABLE 23 RECENT APPLICATIONS/APPROVALS, THROUGH 3/2009 92
• Antidepressant, Anticonvulsants, and Other Pain Relieving Drugs 92
• ANESTHETICS 93
• General 93
• TABLE 24 MOST COMMONLY USED GENERAL ANESTHETIC AGENTS 94
• Local/Regional 94
• Topical 95
• OVER-THE-COUNTER PAIN MANAGEMENT PRODUCTS 95
• ANALGESIC DRUGS 95
• TABLE 25 ACETAMINOPHEN AND ACETAMINOPHEN COMBINATION PRODUCTS 96
• NONSTEROID ANTI-INFLAMMATORY DRUGS 97
• Aspirin Products and Aspirin Combination Products 97
• TABLE 26 ASPIRIN AND ASPIRIN COMBINATION PRODUCTS 98
• Ibuprofen and Ibuprofen Combination Products 98
• TABLE 27 IBUPROFEN AND IBUPROFEN COMBINATION PRODUCTS 98
• Ketoprofen Products 99
• TABLE 28 KETOPROFEN PRODUCTS 99
• Naproxen Compounds 99
• TABLE 29 OTC NONSTEROID ANTI-INFLAMMATORIES 99
• ANTI-MIGRAINE DRUGS 100
• TABLE 30 ANTI-MIGRAINE PRODUCTS 100
• TOPICAL ANESTHETIC DRUGS 100
• TABLE 31 TOPICAL ANESTHETIC PRODUCTS 101
• PAIN MANAGEMENT DEVICES 101
• TRANSCUTANEOUS ELECTRICAL NERVE STIMULATORS 102
• PAIN TEM 103
• SPINAL CORD STIMULATORS 104
• NEUROMUSCULAR STIMULATORS 105
• Neuromuscular Stimulators (Continued) 106
• Neuromuscular Stimulators (Continued) 107
• OTHER PAIN MANAGEMENT DEVICES 108
• PAIN MANAGEMENT PROCEDURES 109
• ALTERNATIVE METHODS OF PAIN MANAGEMENT 109
• ALTERNATIVE METHODS OF PAIN ... (CONTINUED) 110
• Psychological Therapies 111
• Biofeedback 112
• Hypnosis 113
• Behavior Modification/Operant Conditioning 113
• Relaxation and Stress Management Training 113
• Imagery 114
• Autogenic Training 114
• Psychosocial Interventions 115
• Distraction and Reframing 115
• Ice 116
• Warm Bath 116
• Massage 116
• Joint Mobilization 117
• Manipulation 117
• Traction 117
• Acupuncture/Acupressure 117
• Acupuncture/Acupressure (Continued) 118
• Laser Therapy 119
• Surgery 119
• Radiation Therapy 120
• Radio Frequency Neuroablation, Epiduroscopy 120
• PAIN MANAGEMENT SERVICES 121
• HOME CARE 121
• HOSPICE 122
• NATIONAL HOSPICE ORGANIZATION 123
• TABLE 32 NHO COMMITTEES 124
• HOSPITALS 124
• PAIN CLINICS 125
• SKILLED NURSING FACILITIES 126

Chapter-5: TREATING PAIN 44

Chapter-6: PRESCRIPTION PAIN MANAGEMENT MARKET SIZE AND ANALYSIS 6

• TOTAL MARKET 127
• PRESCRIPTION PAIN MARKETS BY PRODUCT TYPE 127
• TABLE 33 WORLDWIDE PRESCRIPTION PAIN MANAGEMENT PHARMACEUTICALS MARKET, THROUGH 2013 ($ MILLIONS) 128
• FIGURE 20 WORLDWIDE PRESCRIPTION PAIN MANAGEMENT PHARMACEUTICALS MARKET, 2006-2013 ($ MILLIONS) 128
• MARKET PARTICIPANTS 129
• TABLE 34 GLOBAL PRESCRIPTION NARCOTIC AND NSAIDS MANUFACTURER MARKET SHARE BY MANUFACTURER, 2008 ($ MILLIONS) 129
• FIGURE 21 GLOBAL PRESCRIPTION NARCOTIC AND NSAIDS MANUFACTURER MARKET SHARE BY MANUFACTURER, 2008 ($ MILLIONS) 130
• TABLE 35 GLOBAL PRESCRIPTION ANTI-MIGRAINE DRUG MANUFACTURER MARKET SHARE BY MANUFACTURER, 2008 ($ MILLIONS) 130
• FIGURE 22 GLOBAL PRESCRIPTION ANTI-MIGRAINE DRUG MANUFACTURER MARKET SHARE BY REVENUE, 2008 (%) 131
• TABLE 36 GLOBAL PRESCRIPTION ANESTHESIA MANUFACTURER MARKET SHARE BY MANUFACTURER, 2008 ($ MILLIONS) 131
• FIGURE 23 GLOBAL PRESCRIPTION ANESTHESIA MANUFACTURER MARKET SHARE BY MANUFACTURER, 2008 (%) 132
• FUTURE MARKET ANALYSIS 132

Chapter-7: PAIN MANAGEMENT DEVICE MARKET SIZE AND ANALYSIS 5

• TOTAL PAIN MANAGEMENT DEVICE MARKET 133
• PAIN MARKETS BY PRODUCT TYPE 133
• TABLE 37 GLOBAL PAIN MANAGEMENT DEVICES MARKET AT MANUFACTURERS' SALES LEVELS BY PRODUCT TYPE, THROUGH 2013 ($ MILLIONS) 134
• FIGURE 24 GLOBAL PAIN MANAGEMENT DEVICES MARKET BY PRODUCT TYPE, THROUGH 2013 ($ MILLIONS) 135
• MARKET PARTICIPANTS 135
• TABLE 38 GLOBAL NEUROMUSCULAR STIMULATOR/TENS MANUFACTURER MARKET SHARE BY MANUFACTURER, 2008 ($ MILLIONS) 136
• FIGURE 25 GLOBAL NEUROMUSCULAR STIMULATOR/TENS UNIT MANUFACTURER MARKET SHARE BY MANUFACTURER, 2008 (%) 136
• TABLE 39 GLOBAL SPINAL CORD STIMULATOR MANUFACTURER MARKET SHARE BY MANUFACTURER, 2008 137
• FIGURE 26 GLOBAL SPINAL CORD STIMULATOR MANUFACTURER MARKET SHARE, 2008 (%) 137
• FUTURE MARKET ANALYSIS 137

Chapter-8: TOTAL MARKET SUMMARY 3

• TOTAL PAIN MANAGEMENT MARKET 138
• TABLE 40 GLOBAL PAIN MANAGEMENT PHARMACEUTICALS AND DEVICES MARKET BY CATEGORY, THROUGH 2013 ($ MILLIONS) 138
• FIGURE 27 GLOBAL PAIN MANAGEMENT PHARMACEUTICALS AND DEVICES MARKET BY CATEGORY, 2006 - 2013 ($ MILLIONS) 139
• MARKET PERCENTAGE BY PRODUCT TYPE 139
• TABLE 41 PERCENT DISTRIBUTION OF THE WORLDWIDE PAIN MANAGEMENT MARKET BY SEGMENT, 2008 (%, $ MILLIONS) 139
• FIGURE 28 PERCENT DISTRIBUTION OF THE WORLDWIDE PAIN MANAGEMENT MARKET BY SEGMENT, 2008 (%) 140

Chapter-9: COMPANY PROFILES 10

• PHARMACEUTICAL PAIN MANAGEMENT MANUFACTURERS 141
• ABBOTT LABORATORIES 141
• ASTRAZENECA 141
• BARR LABORATORIES, INC. 142
• Barr Laboratories, Inc. (Continued) 143
• BAXTER INTERNATIONAL 144
• BRISTOL-MYERS SQUIBB CO. 144
• ELI LILLY & CO. 145
• GLAXOSMITHKLINE 145
• MEDTRONIC, INC. 146
• MERCK & CO., INC. 147
• ORTHO-MCNEIL PHARMACEUTICALS 148
• PFIZER 149
• WYETH 149
• Wyeth (Continued) 150

Chapter-10: APPENDIX I: SELECTED PAIN MANAGEMENT CLINICS BY STATE/ APPENDIX II: COMPANY NAMES AND ADDRESSES 45

APPENDIX I: SELECTED PAIN MANAGEMENT CLINICS BY STATE 151

• PAIN CLINICS 151
• TABLE 42 ALABAMA CLINICS 151
• TABLE 42 (CONTINUED) 152
• TABLE 43 CALIFORNIA PAIN CLINICS 152
• TABLE 43 (CONTINUED) 153
• TABLE 43 (CONTINUED) 154
• TABLE 43 (CONTINUED) 155
• TABLE 43 (CONTINUED) 156
• TABLE 43 (CONTINUED 157
• TABLE 43 (CONTINUED) 158
• TABLE 43 (CONTINUED) 159
• TABLE 43 (CONTINUED) 160
• TABLE 44 COLORADO PAIN CLINICS 160
• TABLE 44 (CONTINUED) 161
• TABLE 45 DELAWARE PAIN CLINICS 161
• TABLE 45 (CONTINUED) 162
• TABLE 46 FLORIDA PAIN CLINICS 162
• TABLE 46 (CONTINUED) 163
• TABLE 46 (CONTINUED) 164
• TABLE 46 (CONTINUED) 165
• TABLE 46 (CONTINUED) 166
• TABLE 46 (CONTINUED) 167
• TABLE 46 (CONTINUED) 168
• TABLE 47 HAWAII PAIN CLINICS 168
• TABLE 48 IOWA PAIN CLINICS 169
• TABLE 49 MAINE PAIN CLINICS 169
• TABLE 50 NEVADA PAIN CLINICS 170
• TABLE 51 OREGON PAIN CLINICS 170
• TABLE 51 (CONTINUED) 171
• TABLE 52 PENNSYLVANIA PAIN CLINICS 171
• TABLE 52 (CONTINUED) 172
• TABLE 52 (CONTINUED) 173
• TABLE 52 (CONTINUED) 174
• TABLE 53 RHODE ISLAND PAIN CLINICS 175
• TABLE 54 SOUTH DAKOTA PAIN CLINICS 175
• TABLE 55 TEXAS PAIN CLINICS 175
• TABLE 55 (CONTINUED) 176
• TABLE 55 (CONTINUED) 177
• TABLE 55 (CONTINUED) 178
• TABLE 56 WASHINGTON PAIN CLINICS 178
• TABLE 56 (CONTINUED) 179
• TABLE 56 (CONTINUED) 180
• PAIN SOCIETIES AND ASSOCIATIONS 180
• INTERNATIONAL ASSOCIATIONS AND ORGANIZATIONS 181

APPENDIX II: COMPANY NAMES AND ADDRESSES 182

• PAIN MANAGEMENT PHARMACEUTICAL MANUFACTURERS 182
• PAIN MANAGEMENT PHARMACEUTICAL ... (CONTINUED) 183
• PAIN MANAGEMENT PHARMACEUTICAL ... (CONTINUED) 184
• PAIN MANAGEMENT PHARMACEUTICAL ... (CONTINUED) 185
• PAIN MANAGEMENT PHARMACEUTICAL ... (CONTINUED) 186
• PAIN MANAGEMENT PHARMACEUTICAL ... (CONTINUED) 188
• PAIN MANAGEMENT PHARMACEUTICAL ... (CONTINUED) 189
• PAIN MANAGEMENT PHARMACEUTICAL ... (CONTINUED) 190
• PAIN MANAGEMENT PHARMACEUTICAL ... (CONTINUED) 191
• PAIN MANAGEMENT PHARMACEUTICAL ... (CONTINUED) 193
• PAIN MANAGEMENT PHARMACEUTICAL ... (CONTINUED) 194
• PAIN MANAGEMENT PHARMACEUTICAL ... (CONTINUED) 195