Pfizer still biggest player in highly prized indication: Datamonitor

Mumbai: With just five approved drugs on the market and millions of patients worldwide, neuropathic pain is one of the most attractive indications in the pharmaceutical industry.

Estimated to be worth over $1.68 billion in 2005, the neuropathic pain market is forecast to grow to $5.5 billion by 2015, driven in the US by strong uptake of Pfizer's Lyrica (pregabalin), Eli Lilly's Cymbalta (duloxetine), and Endo's Lidoderm (lidocaine 5 per cent patch), according to a new report by independent market analyst Datamonitor. Indeed, the pipeline for new treatments is one of the most active in the central nervous system (CNS) arena, with more than 90 compounds in development.

On 18 September 2006, Pfizer received approval from the European Agency for the 'evaluation of medicinal products' (EMEA) to add central neuropathic pain to the label of its new neuropathic pain and epilepsy drug, Lyrica (pregabalin), marking yet another key milestone for one of the industry's fastest growing brands.

For almost a decade Pfizer has dominated the market with its anti-epileptic drug and Lyrica's predecessor, Neurontin (gabapentin), which has been used extensively off-label for a variety of neuropathic pain syndromes, such as painful diabetic neuropathy.

Almost entirely because of the success of Neurontin, which at its peak generated $1.32 billion in disease-specific sales across the seven major markets (UK, US, France, Germany, Italy, Japan and Spain), the neuropathic pain market has become one of the most sought-after indications in the pharmaceutical sector. Coupling several million patients with a strong demand for approved therapies, the growth prospects for a new drug in this market are very attractive.

Neuropathic pain occurs when the nerves malfunction and send pain signals in spite of there being no bodily damage to trigger them. Neuropathic pain frequently presents itself in the limbs of advanced diabetes and HIV sufferers (peripheral neuropathic pain), lower back pain sufferers, and is a characteristic of shingles- also known as post herpetic neuralgia, says Datamonitor CNS senior analyst Ben Greener. "Neuropathic pain can be felt as a burning or stabbing sensation, and can be triggered by non-noxious stimuli (allodynia)."