Pain Management: An Important Market for Drug and Device Makers

Pain is a universal, complex, subjective, multidimensional phenomenon. Pain is responsible for discomfort, sleep disturbance, and interference with daily activities and quality of life.  The understanding of this phenomenon is evolving as scientists from many disciplines conduct research. Increased knowledge provides health care professionals with many strategies for pain management.  Markets for these strategies, including those that are drug-based and device-based are included in the full-study report, The World Market for Pain Management and Devices from Kalorama Information.

Pain is defined as whatever the person experiencing the pain says it is, existing whenever the person says it does. This clinical definition recognizes pain as a personal private experience. Scientists at the International Association for the Study of Pain (IASP) have proposed another definition. This definition states that pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or it is described in terms of such damage.

In considering the IASP definition, it is important to note that not all potentially tissue-damaging stimuli result in pain. Nociception is the activation of the primary afferent nerves with peripheral terminals that respond differently to noxious stimuli. Nociceptors function primarily to sense and transmit pain signals. Nociception may or may not be perceived as pain, depending on a complex interaction within the nociceptive pathways. If nociceptive stimuli are blocked, pain is not perceived.

Finally, it is important to distinguish pain, or nociception, from suffering. Suffering is the state of severe distress associated with events that threaten the intactness of the person. Suffering is an emotion. Pain and suffering are not the same phenomenon. The person who complained of pain in the heart because of the death of a loved one is suffering rather than experiencing pain as it is defined by the IASP. It is clear that three conditions could exist: 1) suffering occurs in the presence of pain, 2) suffering occurs when pain is not present, and 3) pain occurs when suffering is not present. For example, the woman awaiting breast biopsy may suffer because of anticipated loss of her breast. After the biopsy, she may have pain without suffering if the biopsy is negative or pain with suffering if the biopsy is positive for malignancy. Interventions aimed at relieving pain and suffering may have some commonalities, but clearly some interventions for suffering will be inadequate for pain just as some interventions for pain are inadequate for suffering. Therefore, it is crucial to pain management to understand the alterations in comfort that result from suffering and to use the correct term when referring to pain and suffering and to not interchange them.

Pain is one of the most common reasons individuals seek health care. More than 100 million Americans experience pain – both acute and chronic. A significant number of individuals with pain are disabled by their pain, resulting in a serious economic problem in society as well as a major health problem. Adding to the problems of patients with acute pain, especially cancer pain is a tendency for physicians to prescribe small, insufficient doses of analgesics to control the pain.
The world pain management market for drugs and devices encompasses a wide variety of products that treat and ease pain. The field of pain management is currently experiencing a busy and interesting period; and as a result, the range of therapeutic options available to physicians and other clinicians has expanded. Solutions to pain disorders are still elusive but continued human and animal studies will help to further identify the biochemical and neurophysiological factors that influence pain. The future of pain management will likely involve multidisciplinary departments dedicated to finding treatments that manage pain. The need is great worldwide for management of pain and there are still many facets of pain management that need to be explored.


Faced with intensifying competition and increasingly price sensitive markets, manufacturers in the area of pain management therapeutics are trying to differentiate their products to avoid price competition and to increase profits. However, there are a number of issues and trends that have a direct influence on this market and the manufacturer’s ability to successfully operate in the market. A keen awareness of all facets of the industry including barriers will enable manufacturers to effectively challenge these issues and formulate plans to reduce or eliminate barriers in the treatment of pain.


The driving forces for this market include growth and aging of the global population, new products and technology, and increasing interest in multidisciplinary approaches to pain management.
This report, The World Market for Pain Management Drugs and Devices, provides market estimates and forecasts for the following therapeutic categories:
•    Burn Pain
•    Cancer Pain
•    Dental/Facial Pain
•    Migraine Headache Pain
•    Musculoskeletal Pain
•    Neuropathic Pain
•    Obstetrical Pain
•    Pediatric Pain
•    Surgical and Trauma Pain

Kalorama has recently conducted a full length study on pain management.  The report shows significant growth.   can be found at: http://www.kaloramainformation.com/Pain-Management-Drugs-7579512/

Watch Epic in EMR Market

      Six companies lead the market for EMR, according to Kalorama Information.   McKesson, Cerner and Siemens, Epic, Allscripts and GE Healthcare led the market for electronic medical record systems, the healthcare market research publisher noted.    But last year one company in particular demonstrated 28% increase in market growth.   

      The company signaled out Epic Systems of Verona, WI as a game changer in the market. 

      “Epic was like a steamroller in this industry in 2012,” said Mary Ann Crandall, author of the report.  "Part of the strategy is that they court the hospitals and convince them to buy - then the doctors clinics affiliated with that hospital follow suit because of no interoperability with Epic systems.”

       Epic built on its market position with 7.3% of the market.  While still far lower than market leaders, Epic grew from 5.7% in 2011 according to Kalorama’s report while its mid-size rival Allscripts had flat revenues.         

       Allscripts has a better direction now and that it is working diligently on internal problems that had hurt the company in the past. They still have some organizational issues to address but overall they are moving in the right direction.  Internal struggles hampered growth in 2012. With its new management staff, the company hopes to start gaining ground again.  Allscripts Healthcare Solutions is one of the leaders in the physician based EMR solutions. 

         The market  Leaders in the market of EMR providers include large and small companies.  McKesson is a large player the healthcare market and therefore is well-positioned to expand its offerings.  Paragon, Horizon, HERM, Star and Series. Ambulatory offerings include Practice Partners, Practice Point Plus, Fusion and others.       Cerner is continuing to add to its services by adding CernerITWorks, a suite of services that improve the ability of hospital IT departments to meet their organization’s needs.   Siemens offers is the Soarian MedSuite. Soarian MedSuite is a comprehensive and scalable HIS solution that helps organizations to orchestrate complex administrative, clinical and financial processes as well as support critical business activities across the healthcare enterprise.  

      Kalorama Information's report on EMR Markets contains more information on competitive activity in the market, trends, geographic factors and more.  The report can be found at: http://www.kaloramainformation.com/EMR-7503532/

Retail Clinics More Popular with Higher Income Patients: Report

Retail clinics, that is, clinics located in retail outlets such as drug stores, Targets and Walmarts, are more likely to be visited by high-income patients than low-income patients, according to a new Kalorama Information report. The healthcare market research publisher has been covering retail clinics for six years and conducted a survey of US adults to determine retail clinic use and satisfaction. According to Retail Clinics: Consumer Attitudes Results of the 2013 Kalorama Survey. 

Kalorama Information's study sought to identify and describe that group of customers. The firm conducted an online panel of 2,000 U.S. adults 18+ nationwide from Feb 20 to March 9, 2013 querying on a variety of topics related to retail clinics. The panel was apportioned to match U.S. Census demographics. The survey found that just 15% of retail clinic users were from a household with an income under $25,000, while most (59%) had household incomes over $50,000.

Kalorama estimates over 1,300 retail clinics exist in the US. Growth had been hampered by the recession and urgent care competition but boosted by drug store chain strategy. A cornerstone of the convenience clinic business model is low cost services enabled by high throughput and cost containment; a major factor in keeping costs low is the hiring of lower cost staffers. But Kalorama Information didn't find that low cost meant the customers using retail clinics were just those seeking discounts. 

Many more observations about retail clinic visitors and potential clinic visitors are contained in the report, including reasons for visits, gender breakout of retail clinic visitors, best targets for retail clinics and demographics of retail clinics users. The report can be found at http://www.kaloramainformation.com/Retail-Clinics-Consumer-7479194/.

Join Our LinkedIn Site - Available Now: a Free White Paper

Join Kalorama's Linked In Site To Obtain Relevant News From Kalorama Information Reports, and to Network With Other Professionals Across Healthcare Verticals Who Are Interested In Market Research.   Join Our KeyPoint Group and Obtain a Free White Paper on Patient Monitoring Systems.

Becker's Hosptial Review Notes Kalorama Market Projection

An article in Becker's Hospital Review notes Kalorama's finding that the EMR market has exceeded 20 billion dollars, when one counts all EMR-related services that software companies perform, including training and consulting. 

One note: Kalorama has covered this market since 2007, and the market has continued to grow.  One thing that we've noted in recent reports: growth is driven by government incentives that will end in 2014.  For post-incentive growth, EMR vendors will need to do a far better job building a fan base and improving usability and interoperability in their systems. 

Growth in MedDevice Revenues, But Small Growth

Just 3%.  Not the kind of growth that inspires new entrants into a field and venture capital ivestment.  But that was the conlcusion of  our recent report on the medical device industry.   The global medical device market reached 331 billion dollars in 2012    Those companies that did growth launched new products or acquired companies with novel products.

In the U.S. Medicare, Medicaid, as well as state governments implemented anemic spending increases to hospitals, the key buyer of medical device products.   The cuts took the form of non payment for patients for infections acquired at the hospital, or code recovery fees.   In Europe, the extreme economic downturn in Spain, Ireland, Greece and Portugal  led to layoffs and proposed reforms to the health care systems.. Even emerging markets have grown spending less quickly than had been expected.  Hospitals continued to purchase through group organizations and insist on transparent prices. 

The beginning of 2013 saw the medical device industry make the first payments to the IRS for a new 2.3% excise tax on all classes of medical devices, as part of the 2009 Patient Protection and Affordable Care Act (referred to in this report as US healthcare reform.) Many companies attributed layoffs to the tax in widely-publicized announcements, or said that they would not build additional U.S. facilities.  Kalorama didn’t think the device tax factored into slow growth in 2012, but the report does predict long-term effects on venture capital investment and research spending in the industry.

In a slower-growing device market, there was little room for new entrants and giants dominated.  Johnson & Johnson is the world’s largest medical device company, followed by imaging giants GE Healthcare and Siemens and cardiology and spinal device expert Medtronic.  Other leading companies were Stryker, Covidien and Philips. 

Emerging markets were a key strategy for leaders and the report notes a new trend last year: the acquisition of Chinese local companies by device giants. Johnson & Johnson acquired local Chinese company Guangzhou Bioseal Biotechnology Co. Ltd, while Medtronic announced it would acquire China Kanghui Holdings, a developer and producer of trauma and spine orthopedic transplants.

The full report, The Global Market for Medical Devices, 4^th Edition covers these trends, lists company revenues and provides estimates of specific device markets.  The report is available from Kalorama Information at

http://www.kaloramainformation.com/Global-Medical-Devices-7546398/

Another Argument for Urgent Care: Too Many Employer Insured ER Visits

It's not just uninsured that drive up the cost of the ER.  According to this article in Fierce Healthcare most (70%) of visits to ERs by people with employer insurance are unecessary and could have taken place in another venue. 

According to the study cited from a report from Truven Health Analytics.:

"Inappropriate use of emergency department services has become a major source of healthcare system waste," John Azzolini, director of practice leadership at Truven Health Analytics, said in the announcement.  "Conventional wisdom has previously suggested that this issue was confined to the Medicaid, Medicare and uninsured populations, but our new research shows that the privately insured population's use of the ER is avoidable approximately three quarters of the time.

This is one more feather in the cap for urgent care centers, small all services healthcare units which grew at very high rates between 2011 and 2012, according to our recent report.  There are 9,300 in the United States, and this figure is growing.  Urgent care centers can provide more services than a physicians office in most cases, but are not set up for extreme emergencies.  They will be a component of serving the new customers with healthcare insurance, according to Kalorama's recent report.