The overall pain market will maintain $38 billion in sales in 2028 across the major pharmaceutical markets (U.S., France, Germany, Italy, Spain, the U.K. and Japan), according to Burlington, Mass.-based Decision Resources Group.

The loss of sales due to the generic entry of several blockbuster pain therapies in the first half of the 2013-2028 forecast period will be offset by the uptake of emerging agents in current drug classes as well as products representing novel drug classes. Decision Resources Group expects anti-nerve growth factor (anti-NGF) monoclonal antibodies to be the most commercially successful novel analgesic drug class, garnering $7.7 billion in sales by the end of 2028.

Other key findings from the Pharmacor report Novel Approaches to Pain Therapy include:

• The pipeline for early-stage pain therapies remains highly active. There are substantial challenges associated with discovering molecules, biologics and gene therapies that possess suitable clinical profiles for practical pain management.
• Voltage-gated ion channels within pain pathways are a key therapeutic target. Thought leaders interviewed still consider the selective targeting of subtypes of voltage-gated ion channels within pain pathways—particularly Nav1.7— to be an approach that offers significant commercial potential.

Natalie Taylor, Ph.D., Decision Resources Group principal business insights analyst, said, “Pain specialists interviewed by Decision Resources Group reiterate that there still is a great need for pain medications that consistently are effective and that can provide pain relief over the long term. Experts also state that patients with neuropathic pain syndromes are the most inadequately served in terms of effective treatments, and therefore this segment of the pain market offers considerable market opportunity for novel therapies.”

Taylor said, “All novel emerging pain agents will be competing in a market occupied by multiple well-established, inexpensive generic agents. Novel analgesics must offer improvements in efficacy, safety and/or tolerability that are clinically meaningful over generic competitors to gain acceptance from both prescribers and payers. Subtype-selective ion channel modulators hold the potential to specifically target pain pathways and relieve pain in difficult-to-treat neuropathic pain conditions.”