Postoperative Pain - Market Insights, Epidemiology and Market Forecast - 2028

The ‘Postoperative Pain - Market Insights, Epidemiology and Market Forecast - 2028’ report delivers an in-depth understanding of the disease, historical & forecasted epidemiology as well as the market trends of Postoperative Pain in the United States, EU5 (Germany, Spain, Italy, France and the United Kingdom), and Japan.

The report provides the current treatment practices, emerging drugs, market share of the individual therapies, current and forecasted market size of Postoperative Pain from 2017 to 2028 segmented by seven major markets. The report also covers current treatment practice/algorithm, market drivers, market barriers and unmet medical needs to curate best of the opportunities and assess underlying potential of the market.

Geography Covered

• The United States
• EU5 (Germany, France, Italy, Spain and the United Kingdom)
• Japan

Study Period: 2017-2028

Postoperative Pain - Disease Understanding and Treatment Algorithm

The condition which occurs most commonly in patients who undergo surgical procedures is acute postoperative pain or postoperative pain. According to the medical evidence, less than half of patients report adequate postoperative pain relief. The presence of pain often indicates that something is still wrong which can be best judged by the patient on his owns. There are different types of pain that are categorized into two forms, i.e., acute pain and chronic pain (Chou et al., 2016). The intensity, quality, and duration of postoperative pain are affected mainly by Location, type, and duration of the surgical procedure, type of anesthesia, Pain management before and after the surgical procedure, Quality of postoperative care, Incidence of surgical complications, and others.

Acute postoperative pain is a normal response to surgical intervention and is a cause of delayed recovery and discharge after surgery as well as increased risk of wound infection and respiratory or cardiovascular problems. Untreated pain led to reduced patient satisfaction and increased morbidity and mortality and places a burden on the patient and health system finances. Acute pain that becomes inflexible and persists is referred to as chronic postsurgical pain (CPSP).

Acute postsurgical pain occurs secondary to inflammation from tissue trauma or direct nerve injury and can be classified as nociceptive or neuropathic. Tissue trauma releases local inflammatory mediators, which can produce hyperalgesia (increased sensitivity to stimuli in the area surrounding an injury) or allodynia (misperception of pain to no noxious stimuli) (Borsook, Kussman, George, Becerra, & Burke, 2013).

Proper diagnosis of the type and intensity of pain is crucial for an adequate and targeted treatment of acute pain. It requires a highly professional approach in terms of expertise, psychology, and ethics. The patient should feel sufficient understanding on the part of health care professionals. The examination of acute postoperative pain is done by analyzing the medical history, physical examination and evaluation of pain. Specific evaluation of pain includes the location of the pain and its radiation, quality of pain, duration of pain, quality of sleep, accompanying symptoms, and others. Moreover, various grading scales are used for the diagnosis of the pain. Rating scales provide a simple means for patients to rate pain intensity. Typical scales use numeric (e.g., 0-10), verbal (word), or visual (image) descriptors to quantify pain or pain relief. The tool should be appropriate for the patient’s developmental, physical, emotional, and cognitive status, as well as reliable, valid, and easy to use.

The various grading scales are analyzed by the following ways:

• Visual Analogue Scale
• Verbal Rating Scale
• Graded Chronic Pain Scale (GCPS)
• Numeric Rating Scale (NRS)

The other pain assessment tools used include the use of the verbal expression to assess the intensity of pain It allows quick and straightforward evaluation of pain in the elderly, disoriented patients, blind patients, and some children. Multidimensional and nonverbal methods are also used for pain assessment in postoperative cases.

The Postoperative Pain market report gives a thorough understanding of Postoperative Pain by including details such as disease introduction, factors of Postoperative Pain, pathophysiology, diagnosis.

Postoperative Pain Epidemiology

According to the review article by Tong J Gen (2017), surgery and anesthesia are critical health care services that reduce the risk of death and disability among millions worldwide each year, and the need for these services is expected to continue to increase over the next decade. Globally, nearly 313 million operations were performed in 2012. Although possibly life-saving, surgery is also related to potential harm, which normally includes pain during and after the procedure.

The disease epidemiology covered in the report provides historical as well as forecasted epidemiology scenario of Postoperative Pain in the 7MM covering United States, EU5 countries (Germany, Spain, Italy, France and United Kingdom) and Japan from 2017-2028 for the following aspects:

The disease epidemiology covered in the report is segmented by:

• Total number of surgical procedures
• Total number of Incident cases of Postoperative Pain
• Severity-specific incident cases of Postoperative Pain

As per the analysis, in 2017 the total number of incident cases of postoperative pain in the US was 40,314,731. The main reasons behind increased cases are due to increase morbidity, reduced physical function and quality of life, increased cost of care, bad recovery, preexisting pain, and prolonged opioid use during and after hospitalization.

Further, according to the publisher, in 2017, it is estimated that the severity-specific incident cases of postoperative pain in France were 1,194,644, 1,439,003 and 828,105 in mild, moderate and severe cases respectively. Additionally, Japan was observed with 12,134,677 incident cases for postoperative pain in 2017.

A study was conducted by Marinangeli et al. (2009) to know the treatment of acute pain in the prehospital emergency setting remains a significant problem. The study evaluated the incidence, site, and possible cause of acute pain in the prehospital period and also the current state of prehospital pain management by assessing analgesic availability in emergency vehicles in Italy. The study concluded that pain symptoms were present in approximately two-thirds of the patients (n = 383) and ranked as moderate to unbearable in 41.75%. Results of the analgesic availability survey specify that 10.6% of the ambulance services carry no pain killers (including nonsteroidal anti-inflammatory drugs [NSAIDs] and/or paracetamol) and 11.5% are without an opioid. The pain evaluation was calculated which showed that 32.5% had no pain, 22% showed slight pain, 26.5% showed moderate pain, 12% patient felt severe pain, 3.25% patient could not bear the pain, and 3.75% patient were not defined in the scale (Marinangeli et al., 2009).

Postoperative Pain Drug Chapters

This segment of the Postoperative Pain report encloses a detailed analysis of the drugs that are expected to be launched in other regions. It also helps to understand the clinical trial details, expressive pharmacological action, agreements and collaborations, approval and patent details, advantages and disadvantages of each included drug and the latest news and press releases.

Expected launch of potential therapies may increase the market size in the coming years, assisted by an increase in the prevalent population of Postoperative Pain and awareness of the disease. The overall dynamics of the Postoperative Pain market is anticipated to change in the coming years owing to the expected launch of emerging therapies that are already approved in specific regions but are expected to be launched in other regions as well. The major key players such as Heron Therapeutics, Cara Therapeutics, Trevena and others will significantly increase the market during the forecast period (2019-2028).

Postoperative Pain Market Outlook

Currently, the treatment pattern consists of different classes of drugs that are classified into pharmacologic and nonpharmacological therapies. The pharmacological therapies include analgesics that are further segregated into opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen respectively. The acute pain is also managed by the use of benzodiazepines, muscle relaxants, antidepressants, alpha-2 agonists, gamma-aminobutyric agonists, and cannabinoids. Further, nonpharmacological therapies include acupuncture, psychological approaches (cognitive behavioral therapy, mindfulness-based stress reduction), chiropractic manipulation, physical therapy, transcutaneous electrical stimulation, massage therapy, exercise, and other complementary and alternative medicine therapies (CAM).

Opioids are a large group of pain-relieving drugs that are used for reducing the pain in the postoperative cases. These drugs majorly include fentanyl, hydromorphone, morphine, oxycodone, oxymorphone, and tramadol. Also, non-steroidal anti-inflammatory drugs (NSAIDs) are a sensible choice because of their effectiveness after surgical procedures. However, before surgeons start prescribing NSAIDs in place of opioids, it is crucial first to understand their potential post-surgical complications. NSAIDs provide anti-inflammatory, antipyretic, analgesic and thrombotic effects through the inhibition of the enzymes cyclooxygenases 1 and 2 (COX-1 and COX-2). Although several generics are available for NSAIDs and presence of generics in the market is due to patent expiration. Paracetamol is the most commonly used analgesic with analgesic and antipyretic action. Even though it has been widely available for a long time, its exact mechanism of action is still unknown.

In addition to this, in September 2015, Zalviso was approved by the European Commission (EC) for the management of acute moderate-to-severe pain in adult patients in the hospital setting. The drug is a synthetic, potent opioid with highly selective binding to µ-opioid receptors. Another approved drug in the European Union is Maxigesic, which is approved in Austria, Belgium, Croatia, France, Germany, Luxembourg, Netherlands, Portugal, and Spain in May 2017. The drug reduces fever and provides temporary relief of pain associated with headache, migraine headache, tension headache, sinus pain, toothache, dental procedures, backache, sore throat, arthritis, tennis elbow, period pain, muscular pain, rheumatic pain, aches and pains associated with colds and flu.

Dsuvia is an opioid agonist contains sufentanil and is indicated for use in adults in a certified medically supervised healthcare setting, such as hospitals, surgical centers, and emergency departments, for the management of acute pain. Dsuvia is administered in the form of the tablet sublingually to the patient. Also, it is approved as a brand name Dzuveo in Europe and is effective in reducing severe pain following surgeries.

The postoperative pain pipeline possesses potential drugs in late and mid developments to be launched in the near future. The major key players include Olinvo (Trevena), HTX-011 (Heron Therapeutics), and CR845/Difelikefalin (Cara Therapeutics).

Olinvo (Trevena) is a novel G protein biased (selective) mu-opioid receptor (MOR) ligand which is in development for the management of moderate-to-severe acute pain in hospitals or other controlled clinical settings where IV opioid therapy is warranted. The drug is currently in phase III clinical developmental trial.

Heron Therapeutics is developing a potent drug HTX-011 (bupivacaine and meloxicam) which is in phase III developmental trial. The drug is a fixed-dose combination of the local anesthetic bupivacaine with the nonsteroidal anti-inflammatory drug (NSAID) meloxicam. In December 2018, the US FDA accepted the new drug application (NDA) for HTX-011 and also granted a Priority Review designation.

This segment gives a thorough detail of market trend of each therapy by evaluating their impact based on annual cost of therapy, inclusion and exclusion criteria’s, mechanism of action, growing need of the market, increasing patient pool, covered patient segment, expected launch year, competition with other therapies, brand value, their impact on the market and view of the key opinion leaders. The calculated market data are presented with relevant tables and graphs to give a clear view of the market at first sight.

According to the publisher, the market of Postoperative Pain in the 7MM is expected to change from 2019-2028.

Postoperative Pain Drugs Uptake

This section focusses on the rate of uptake of the potential drugs recently launched in the market or will get launched in the market during the study period from 2017-2028. The analysis covers market uptake by drugs; patient uptake by therapies and sales of each drug.

This helps in understanding the drugs with the most rapid uptake, reasons behind the maximal use of new drugs and allows the comparison of the drugs on the basis of market share and size which again will be useful in investigating factors important in market uptake and in making financial and regulatory decisions.

Approval of therapies for Postoperative Pain such as Maxigesic (AcelRx Pharmaceuticals; to be launched in US and Japan), HTX-011 (Heron Therapeutics; to be launched in US, EU and Japan), Olinvo (Trevena; to be launched in US, EU and Japan), CR845 (Cara Therapeutics; to be launched in US, EU and Japan), and other targeted therapies in the forecast period [2019-2028] will also create a positive impact on the Postoperative Pain market.

The market is anticipated to show an extensive boost due to projected label expansion of the current therapies and emergence of potential pipeline products as approved therapies in the near future. The market size of Postoperative in the seven major markets in 2017 was USD 1,067.82 Million in 2017. Japan accounts for the least market size in the 7MM during the forecast period 2017-2028, at a CAGR of 7.41% for the study period (2017-2028). Among the EU5 countries, Germany had the highest market size with USD 49.89 Million in 2017, while Spain had the lowest market size of postoperative pain.

Postoperative Pain Report Insights

• Patient Population
• Therapeutic Approaches
• Market Size and Trends
• Market Opportunities
• Impact of upcoming Therapies
• Postoperative Pain Report Key Strengths
• 10-Year Forecast
• 7MM Coverage
• Epidemiology Segmentation
• Drugs Uptake
• Highly Analyzed Market
• Key Cross Competition
• Postoperative Pain Report Assessment
• Current Treatment Practices
• Unmet Needs
• Market Attractiveness
• Market Drivers and Barriers

Key Benefits

• This report will help to develop Business Strategies by understanding the trends shaping and driving the Postoperative Pain market
• Organize sales and marketing efforts by identifying the best opportunities for Postoperative Pain market
• To understand the future market competition in the Postoperative Pain market.