Neglected cancer pain drugs: huge market potential, insufficient investment in drug research and development

At present, the market of cancer pain treatment drugs is still a small market, but the increasing number of cancer pain patients will drive the continuous growth of the market demand for pain management drugs in China in the future At present, the R & D investment of new drugs and generic drugs in this field is insufficient Cancer pain refers to the pain directly caused by cancer or cancer-related diseases and cancer treatment Cancer pain is usually chronic As NCCN adult cancer pain guidelines 2016 is more specific, measurable and patient-centered in the purpose of pain management, more and more attention has been paid to multidisciplinary professional participation, including interventional therapy, physical therapy, psychosocial support services, psychiatric consultation, pain and nursing services, drug consultation, depression / pain consultation, spiritual care consultation, social work services And so on For the use of strong analgesics, the NCCN guidelines also want to avoid inappropriate administration (i.e do not increase the dosage or frequency of administration by yourself) in addition to requiring a prescription and limiting the use to patients themselves Oral medicine is basically not limited by medical insurance, but some of them are controlled drugs From the western medicine part of the medical insurance catalogue in 2017, it can be seen that the commonly used dosage forms of cancer pain drugs in the cancer pain guide are mainly injection and patch, while the limited use of oral slow-release agents and slow-release and controlled-release drugs is less The most commonly used medicine for cancer pain is oral administration, followed by patch or anal suppository Because of the disadvantages of easy drug resistance, short analgesia time and large side effects, injection is not the mainstream in the treatment of cancer pain In addition, many cancer pain drugs are controlled drugs, such as sufentanil citrate injection, fentanyl transdermal patch, tramadol hydrochloride tablets, tramadol hydrochloride injection, oxycodone hydrochloride sustained-release tablets, codeine phosphate tablets and morphine sulfate tablets At present, it is more used for postoperative analgesia In the future, it can be seen from table 3 that the drugs mentioned in the cancer pain guide are all injections, and the indications are not only cancer pain For example, flurbiprofen injection is mainly used in emergency, general surgery and orthopedics, and postoperative analgesia is the most important prescription application Zoledronic acid injection is widely used not only in oncology, but also in surgery and orthopedics The leading oral medicine is not only for cancer pain treatment, but also for depression At present, there is no very clear data about the market scale of prescriptions in cancer pain drugs However, with the increase of cancer incidence in China, the market scale of cancer pain drugs is expected New drugs and generic drugs for cancer pain: it was found that there were 3 drugs with clear indications of cancer pain in the drugs that started clinical practice after 2015 Pfizer pf-04383119 injection is a biological product, the indications of treatment are related to bone metastasis and cancer, and it is expected to be mainly used for the treatment of bone pain In 2010, anilofen injection was approved as a national major new drug development project, and phase I clinical trial was started in 2013, and it is still in phase I clinical trial in 2017 At present, flurbiprofen axetil injection is the exclusive sale of the original research institute Wuhan Da'an flurbiprofen axetil injection has entered the first self-examination clinical verification catalog, and started the clinical work again after it was withdrawn In September 2017, Chongqing Yaoyou was approved for clinical work It is still unknown who will spend the first copy It is worth noting that many cancer pain drugs are controlled drugs in the catalogue, such as buprenorphine transdermal patch, which improves the entry threshold of the industry At present, only Germany lts Lohmann therapie System Ag (Mengti China Pharmaceutical Co., Ltd.) is on the market in China Compared with cancer pain, there have been more clinical trials of postoperative pain relief since 2015, mainly focusing on the imitation of ibuprofen injection, The enterprises involved include Shaanxi Tianyu pharmaceutical, Shenyang Shuangding pharmaceutical, Jiangsu Jiuxu pharmaceutical, Shandong Luoxin pharmaceutical, Hainan Herui pharmaceutical, Yangzijiang Pharmaceutical Group Nanjing Hailing pharmaceutical, Hainan Puli pharmaceutical, Beijing ailijia pharmaceutical, Sichuan directional pharmaceutical, Hebei United pharmaceutical, Nanjing ruinian balance pharmaceutical, Chengdu Tiantaishan pharmaceutical, Tianjin hankang pharmaceutical Summary: the cancer pain drug market will enter a rapid growth period due to the increase in the number of patients with severe pain Previously, it has been reported that more than half of cancer patients in China have not received cancer pain treatment, and 30% - 50% of pain patients have not received standard pain treatment, which has huge market potential in China In the treatment of severe pain, opioid analgesics still occupy the main market of pain management drugs However, opioids are controlled drugs in China, so it is difficult to access them Ibuprofen injection is a hot spot in the near future In addition to drugs, nerve stimulation equipment (spinal cord stimulation, deep brain stimulation, vagus nerve stimulation, sacral nerve stimulation, etc.) and other medical devices for neuralgia will also occupy a leading market position.