PUBLISHER: DelveInsight | PRODUCT CODE: 1415490
PUBLISHER: DelveInsight | PRODUCT CODE: 1415490
Various key players are leading the treatment landscape of postoperative acute pain, such as Taiwan Liposome Company, Teikoku Pharma, Formosa Pharmaceuticals, and others. The details of the country-wise and therapy-wise market size have been provided below.
The section dedicated to drugs in the postoperative acute pain report provides an in-depth evaluation of late-stage pipeline drugs (Phase III and Phase II) related to postoperative acute pain.
The drug chapters section provides valuable information on various aspects related to clinical trials of postoperative acute pain, such as the pharmacological mechanisms of the drugs involved, designations, approval status, patent information, and a comprehensive analysis of the pros and cons associated with each drug. Furthermore, it presents the most recent news updates and press releases on drugs targeting postoperative acute pain.
DEXTENZA is a corticosteroid intracanalicular insert placed in the punctum, a natural opening in the eyelid, and into the canaliculus and is designed to deliver dexamethasone to the ocular surface for up to 30 days without preservatives. In June 2019, Ocular Therapeutix announced that the US FDA had approved an sNDA for DEXTENZA to include the treatment of ocular inflammation following ophthalmic surgery as an additional indication.
Taiwan Liposome Company (TLC) is developing TLC590, a fast onset, long-lasting, nonopioid postsurgical local anesthetic that brings sustained release delivery technology to the common anesthetic ropivacaine, intending to reduce the frequency of administration for local anesthesia for postsurgical pain. In the Phase II clinical trial, patients undergoing bunionectomy, demonstrated greater pain reductions than placebo and bupivacaine through 168 h, with statistically significant pain relief 0-12, 0-24, 0-36, and 0-48 h (p < 0.05). Currently, TLC590 is in Phase II/III of development for postsurgical pain management following inguinal hernia repair.
Most surgical patients experience acute postoperative pain, but evidence suggests that less than half report adequate postoperative pain relief. Many pre-operative, intra-operative, and postoperative interventions and management strategies are available for reducing and managing postoperative pain.
The treatment pattern currently consists of different approaches classified into pharmacologic and nonpharmacological therapies. The pharmacological therapies include analgesics that are further segregated into opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, corticosteroids, anesthetics, etc.
In recent years, extensive changes have been observed in the postoperative pain management market. Opioid replacement with other more beneficiary approaches has been in talks. Opioid was a gold standard but is being replaced by multimodal analgesia (MMA) models.
Recently, FDA has emphasized issues like opioid drug abuse; opioid sparing is a relatively new consideration for the FDA, and the review of such effects is still a matter of debate. Nevertheless, nonopioid agents will profit due to the ongoing epidemic; thus, the future of long-acting local anesthetics is quite bright.
Pain relief after surgery continues to be a major medical challenge. Poorly managed postoperative pain may delay discharge and recovery, and result in the patient's inability to participate in rehabilitation programs, leading to poor outcomes. There is a major unmet need for recent advances that include a better understanding of pain mechanisms, physiology, and pharmacology, the publication of guidelines, the establishment of acute pain services (APSs), initiatives such as 'pain as the fifth vital sign' and availability of new drugs and devices.
Acute postoperative pain is a normal response to surgical intervention. It is a cause of delayed recovery and discharge after surgery as well as an increased risk of wound infection and respiratory or cardiovascular problems. Untreated pain reduces patient satisfaction, increased morbidity and mortality, and causes financial burdens. Acute pain that becomes inflexible and persists is referred to as chronic postsurgical pain (CPSP).
It 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).
It is a common misconception that acute pain is momentary or transient. However, depending on the type of injury, it may last for weeks or even months. Typically, treating the underlying cause of acute pain causes it to resolve. In cases where the pain cannot be relieved, it may become chronic. The transition from acute to chronic pain is an experimental entity associated with an enormous burden on the healthcare system. Terminating acute nociception and full tissue recovery would restore normal homeostasis and end the pain process. However, continuous or repetitive nociceptive stimulation leads to pathophysiological changes in pain processing. Complex changes are observed at all levels, from the edge to the brain resulting in persistent pain
For efficient treatment, it needs to be properly diagnosed, measured, and documented. Only by this procedure, optimal analgesia may be achieved, a mild and tolerable sensation of pressure in the surgical wound with minimal adverse effects. 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.
Specific evaluation of pain includes the location of the pain and its radiation, quality of the pain (dull, sharp, throbbing, shooting, burning, etc.), duration of the pain (constant, intermittent, paroxysmal), causative factors (movement, sitting position, cough, etc., the intensity of the pain at rest or during movement), accompanying symptoms, quality of sleep, assessment of the patient's expectations, personal approach to pain, stress, and pain coping strategies, analgesic therapy preferences.
Postoperative pain management aims not only to decline pain intensity but also to increase patient comfort and to improve postoperative outcomes. Effective pain control is achieved through multiple combinations of regional analgesic techniques and systemic administration of analgesic agents.
Pharmacologic therapies for pain include drugs from several drug classes. Pain-relieving analgesics include opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen. Providers also elect to manage acute pain with benzodiazepines, muscle relaxants, antidepressants, alpha-2 agonists, gamma-aminobutyric agonists, and cannabinoids. Topical agents, such as capsaicin and lidocaine are also used. Medications for pain management have some associated harms, and some of them are even serious. Therefore, caution is necessary when prescribing pharmacologic pain treatment, especially in certain populations (such as older adults, individuals with comorbidities and/or polypharmacy or a history of substance abuse, pregnant and breastfeeding women, and children and adolescents).
Nonpharmacologic therapies for pain are becoming more widely used to avoid problems associated with pharmacologic therapies. Examples of nonpharmacologic 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).
The postoperative acute pain epidemiology chapter in the report provides historical as well as forecasted epidemiology segmented by total incident cases, visit-specfic surgical cases, and severity-specific cases of postoperative acute pain in the United States from 2019 to 2032.
To stay abreast of the latest trends in the market, we conduct primary research by seeking the opinions of Key Opinion Leaders (KOLs) and Subject Matter Experts (SMEs) who work in the relevant field. This helps us fill any gaps in data and validate our secondary research.
We have reached out to industry experts to gather insights on various aspects of postoperative acute pain, including the evolving treatment landscape, patients' reliance on conventional therapies, their acceptance of therapy switching, drug uptake, and challenges related to accessibility. The experts we contacted included medical/scientific writers, professors, and researchers from prestigious universities in the US, Europe, the UK, and Japan.
Our team of analysts at Delveinsight connected with more than 15 KOLs across the 7MM. We contacted institutions such as the Massachusetts General Hospital, University of Minnesota, University of Michigan, etc., among others. By obtaining the opinions of these experts, we gained a better understanding of the current and emerging treatment patterns in the postoperative acute pain market, which will assist our clients in analyzing the overall epidemiology and market scenario.
We perform Qualitative and Market Intelligence analysis using various approaches, such as SWOT analysis and Conjoint Analysis. In the SWOT analysis, strengths, weaknesses, opportunities, and threats in terms of disease diagnosis, patient awareness, patient burden, competitive landscape, cost-effectiveness, and geographical accessibility of therapies are provided. These pointers are based on the Analyst's discretion and assessment of the patient burden, cost analysis, and existing and evolving treatment landscape.
Conjoint Analysis analyzes multiple approved and emerging therapies based on relevant attributes such as safety, efficacy, frequency of administration, designation, route of administration, and order of entry. Scoring is given based on these parameters to analyze the effectiveness of therapy.
In efficacy, the trial's primary and secondary outcome measures are evaluated; for instance, in trials for postoperative acute pain, one of the most important primary endpoints were measure of the anterior chamber cells (ACC) treatment difference, pain-free patient pool or reduction in ocular pain after the treatment, etc. Based on these, the overall efficacy is evaluated.
Further, the therapies' safety is evaluated wherein the acceptability, tolerability, and adverse events are majorly observed, and it sets a clear understanding of the side effects posed by the drug in the trials. In addition, the scoring is also based on the route of administration, order of entry and designation, probability of success, and the addressable patient pool for each therapy. According to these parameters, the final weightage score and the ranking of the emerging therapies are decided.
Because newly authorized drugs are often expensive, some patients escape receiving proper treatment or use off-label, less expensive prescriptions. Reimbursement plays a critical role in how innovative treatments can enter the market. The cost of the medicine, compared to the benefit it provides to patients who are being treated, sometimes determines whether or not it will be reimbursed. Regulatory status, target population size, the setting of treatment, unmet needs, the number of incremental benefit claims, and prices can all affect market access and reimbursement possibilities.
The report further provides detailed insights on the country-wise accessibility and reimbursement scenarios, cost-effectiveness scenario of approved therapies, programs making accessibility easier and out-of-pocket costs more affordable, insights on patients insured under federal or state government prescription drug programs, etc.