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The patient populations for neuropathic and nociceptive pain are large, and are driven by separate disease trends that necessitate pain relief; across the seven major markets in 2005 it was estimated that 37.6m individuals suffered from neuropathic pain and 170.1m suffered from nociceptive pain. The major constituents of the neuropathic pain market are lower back pain, neuralgia/fibromyalgia, diabetic neuropathic pain and pain associated with multiple sclerosis. The nociceptive pain market is driven by the prevalence of the major indications of arthritic pain, particularly osteoarthritis and rheumatoid arthritis, post-operative pain, cancer-related pain and HIV-related pain. Current management of pain is mostly pharmacological consisting of the use of opioids, non-opioids and non-steroidal anti-inflammatory drugs (NSAIDs), as well as adjuvant therapies such as anti-depressants and anti-convulsants. Although pain is not a new phenomenon, misdiagnosis and under-treatment continue to prove deleterious to the pain market. Increased education for patients, physicians, nurses and pharmacists is an on-going unmet need that must be addressed. Across the seven major markets, it is forecast that the prevalence of both the neuropathic and nociceptive markets will increase modestly. It is forecast that the prevalence of the neuropathic pain market will increase to 39.1m individuals, which is complimented by the forecast growth of the nociceptive market to include 164.8m individuals in 2011.

Table of Contents
The Pain Market Outlook to 2011
Executive Summary 10
Patient potential 10
Global market analysis 11
Analysis of potential future blockbusters 12
Leading players in the global pain market 13
Chapter 1 Patient potential 16
Summary 16
Introduction 17
Neuropathic pain 18
Lower back pain 19
Background 19
Diagnosis, treatment and management 20
Epidemiology 21
Neuralgia/fibromyalgia 23
Background 23
Diagnosis, treatment and management 24
Epidemiology 25
Diabetic neuropathic pain 27
Background 27
Diagnosis, treatment and management 28
Epidemiology 29
Pain associated with multiple sclerosis 31
Background 31
Diagnosis, treatment and management 33
Epidemiology 34
Nociceptive pain 36
Arthritic pain 36
Background 36
Diagnosis, treatment and management 37
Epidemiology 38
Post-operative pain 41
Background 41
iv
Diagnosis, treatment and management 41
Epidemiology 42
Cancer-related pain 43
Background 43
Diagnosis, treatment and management 45
Epidemiology 45
HIV related pain 47
Background 47
Diagnosis, treatment and management 49
Epidemiology 49
Chapter 2 Global market analysis 54
Summary 54
Introduction 55
Pain market analysis 55
Leading brands in the global pain market 58
Opioid market analysis 61
Leading brands in the global opioid market 62
Long-acting opioid market analysis 64
Key brands analysis 64
Short-acting opioid market analysis 72
Key brands analysis 72
Class sales forecast to 2011 75
Non-opioid market analysis 76
Leading brands in the non-opioid market 77
Key brands analysis 79
Class sales forecast to 2011 82
Non-steroidal anti-inflammatory drugs 83
Leading brands in the NSAID market 83
Key brands analysis 85
Class sales forecast to 2011 89
Cox-II inhibitor market analysis 90
Leading brands in the COX-II inhibitor market 91
Key brands analysis 93
Class sales forecast to 2011 98
Anti-convulsants market analysis 99
Leading brands in the anti-convulsant market 100
First-generation anti-convulsants 102
Key brands analysis 102
Second-generation anti-convulsants 106
Key brands analysis 106
Class sales forecast to 2011 115
Global pain market forecasts to 2011 116
v
Chapter 3 Analysis of potential future
blockbusters 120
Summary 120
Introduction 121
Major approaches to R&D 122
Leading drugs in development 123
Drug profiles 124
Phase II pipeline drugs 124
NW-1029 (ralfinamide) 124
Phase III pipeline drugs 125
Tapentadol (CG5503/R33133) 125
Bicifadine 128
Transacin (NGX-4010) 131
Neurodex (dectromorphan/quinidine) 134
Chronogesic (sufentanil) 136
Lacosamide 138
M6G (morphine-6-glucuronide) 140
Licofelone (ML3000) 141
Recently marketed drugs 144
Lyrica (pregabalin) 144
Prialt (ziconotide) 147
IONSYS (fentanyl iontophoretic transdermal system) 149
DepoDur (morphine) 151
Prexige (lumiracoxib) 153
Forecast sales potential 157
Chapter 4 Leading players in the global pain
market 160
Summary 160
Introduction 161
Global market shares 162
Pfizer 165
Marketed products 165
R&D compounds 167
Pain portfolio forecasts to 2011 168
Johnson & Johnson 170
Marketed products 170
R&D compounds 171
Pain portfolio forecasts to 2011 173
Novartis 175
vi
Marketed products 175
R&D compounds 177
Pain portfolio forecasts to 2011 178
GlaxoSmithKline 180
Marketed products 180
R&D compounds 182
Pain portfolio forecasts to 2011 184
Mundipharma Int. 185
Marketed products 185
R&D compounds 186
Pain portfolio forecasts to 2011 187
Abbott 188
Marketed products 188
R&D compounds 189
Pain portfolio forecasts to 2011 190
Boehringer Ingelheim 192
Marketed products 192
R&D compounds 193
Pain portfolio forecasts to 2011 194
Sanofi-Aventis 195
Marketed products 195
R&D compounds 196
Pain portfolio forecasts to 2011 197
Chapter 5 Appendix 200
IMS sales data 200
Index 201
Glossary 204
vii
List of Figures
Figure 1.1: Types of diabetic neuropathy 28
Figure 1.2: Types of pain in multiple sclerosis 32
Figure 1.3: Types of nociceptive cancer-related pain 44
Figure 1.4: Sources of nociceptive HIV-related pain 48
Figure 2.5: Competitive dynamics of the global pain market by drug class, 2005 57
Figure 2.6: Competitive dynamics of the leading products in the global pain market, 2005 60
Figure 2.7: Competitive dynamics of the leading opioid products in the global pain market, 2005
64
Figure 2.8: Competitive dynamics of the leading non-opioid products in the global pain market,
2005 79
Figure 2.9: Competitive dynamics of the leading NSAID products in the global pain market, 2005
85
Figure 2.10: Competitive dynamics of the leading COX-II inhibitor brands in the global pain
market, 2005 93
Figure 2.11: Competitive dynamics of the leading anti-convulsant products in the global pain
market, 2005 102
Figure 3.12: Leading recently launched products and late-stage R&D compounds indicated for the
treatment of pain, 2006 123
Figure 4.13: Key players in the global pain market, 2001 and 2005 164
List of Tables
Table 1.1: Estimated prevalence of neuropathic and nociceptive pain in the seven major
pharmaceutical markets, 2005 17
Table 1.2: Estimated prevalence of neuropathic lower back pain in the seven major
pharmaceutical markets, 2005 22
Table 1.3: Forecast prevalence of neuropathic lower back pain across the seven major markets,
2005–11 23
Table 1.4: Estimated prevalence of neuralgia/fibromyalgia pain in the seven major
pharmaceutical markets, 2005 25
Table 1.5: Forecast prevalence of neuralgia/fibromyalgia across the seven major markets, 2005–
11 26
Table 1.6: Estimated prevalence of diabetic neuropathic pain (DNP) in the seven major
pharmaceutical markets, 2005 30
Table 1.7: Forecast prevalence of diabetic neuropathic pain across the seven major markets,
2005–11 31
Table 1.8: Estimated prevalence of multiple sclerosis (MS) in the seven major pharmaceutical
markets, 2005 34
Table 1.9: Forecast prevalence of pain associated with multiple sclerosis across the seven major
markets, 2005–11 35
Table 1.10: Estimated prevalence of OA-related pain in the seven major pharmaceutical markets,
2005 38
Table 1.11: Estimated prevalence of RA pain in the seven major pharmaceutical markets, 2005 39
viii
Table 1.12: Forecast prevalence of OA and RA related pain across the seven major markets, 2005–
11 40
Table 1.13: Estimated prevalence of post-operative pain in the seven major pharmaceutical
markets, 2005 42
Table 1.14: Forecast prevalence of post-operative pain across the seven major markets, 2005–11 43
Table 1.15: Estimated prevalence of cancer-related pain in the seven major pharmaceutical
markets, 2005 46
Table 1.16: Forecast prevalence of cancer-related pain across the seven major markets, 2005–11 47
Table 1.17: Estimated prevalence of HIV-related pain in the seven major pharmaceutical markets,
2005 50
Table 1.18: Forecast prevalence of HIV-related pain across the seven major markets, 2005–11 51
Table 2.19: Breakdown of the global pain market by drug class, 2001-05 56
Table 2.20: Leading brands in the global pain market, 2004–05 58
Table 2.21: Leading brands in the global opioid market, 2004–05 62
Table 2.22: Sales forecasts for opioids in the global pain market, 2005–11 75
Table 2.23: Leading non-opioid products in the global pain market, 2004–05 78
Table 2.24: Sales forecasts for non-opioids, 2005–11 82
Table 2.25: Leading NSAIDs in the global pain market, 2004–05 84
Table 2.26: Sales forecasts for NSAIDs in the global pain market, 2005–11 89
Table 2.27: Leading COX-II inhibitor brands in the global pain market, 2004–05 92
Table 2.28: Sales forecasts for COX-II inhibitors, 2005–11 98
Table 2.29: Leading anti-convulsant products in the global pain market, 2004–05 100
Table 2.30: Sales forecasts for anti-convulsants in the global pain market, 2005–11 115
Table 2.31: Sales forecasts in the global pain market, 2005–11 116
Table 3.32: Sales forecasts for key recently launched products and R&D compounds, 2005–11 157
Table 4.33: Key players in the global pain market, 2005 162
Table 4.34: Pfizer’s marketed pain portfolio, 2005 166
Table 4.35: Pfizer’s pain R&D pipeline, 2006 167
Table 4.36: Forecast sales for Pfizer’s pain portfolio, 2005-11 168
Table 4.37: J&J’s marketed pain portfolio, 2005 170
Table 4.38: J&J’s pain R&D pipeline, 2006 171
Table 4.39: Forecast sales for J&J’s pain portfolio, 2005–11 173
Table 4.40: Novartis’ marketed pain portfolio, 2005 175
Table 4.41: Novartis’ pain R&D pipeline, 2006 177
Table 4.42 Forecast sales for Novartis’ pain portfolio, 2005–11 179
Table 4.43 GSK’s marketed pain portfolio, 2005 180
Table 4.44: GSK’s pain R&D pipeline, 2006 182
Table 4.45: Forecast sales for GSK’s pain portfolio, 2005–11 184
Table 4.46: Mundipharma’s marketed pain portfolio, 2005 186
Table 4.47: Forecast sales for Mundipharma’s pain portfolio, 2005–11 187
Table 4.48: Abbott’s marketed pain portfolio, 2005 189
Table 4.49: Abbott’s pain R&D pipeline, 2006 189
Table 4.50: Forecast sales for Abbott’s pain portfolio, 2005–11 191
Table 4.51: Boehringer Ingelheim’s marketed pain portfolio, 2005 192
Table 4.52: Forecast sales for Boehringer Ingelheim’s pain portfolio, 2005–11 194
Table 4.53: Sanofi-Aventis’ marketed pain portfolio, 2005 195
Table 4.54: Sanofi-Aventis’ pain R&D pipeline, 2006 196
Table 4.55: Forecast sales for Sanofi-Aventis’ pain portfolio, 2005–11 197