Before the world was dealing with the COVID-19 pandemic, another public health emergency was on the minds of everyone: the opioid abuse crisis. Opioid use disorder (OUD) is a chronic condition characterized by a compulsive, prolonged, repeated self-administration of opioids. Patients can be addicted to either prescription opioids such as hydrocodone, oxycodone, morphine, codeine, and fentanyl or non-medical opioids such as heroin. Prescription opioids are mostly used to treat moderate to severe pain, with some types also used to treat cough and diarrhea. In addition to relieving the medical conditions for which they were prescribed, they make a person feel very relaxed and euphoric which is why they’re also used for non-medical purposes.
Today’s market size shows the global revenues for drugs used in the treatment of OUD in 2018 and projected for 2026. Worldwide more than 53 million people aged 15-64, or 1.1% of that population, abused opioids in 2019. Sixty-six percent of global drug overdose deaths associated with drug use disorders were related to opioids. In the United States in 2018, 2.9 million people aged 15 and older suffered from OUD. According to the U.S. Centers for Disease Control, 130 people in the United States die from an opioid overdose every day. In 2017, 9% of overdose deaths linked to opioids occurred in people under the age of 25. The United States declared the opioid abuse crisis a public health emergency on October 27, 2017.
Treatment for OUD involves Medication-Assisted Treatment (MAT) with an opioid agonist or opioid antagonist in order to mitigate the cravings and the withdrawal symptoms that come from detoxification without producing the euphoria that the abused drug caused. MAT also includes behavioral therapy and counseling. Opioid agonists activate the same opioid receptors that drugs such as heroin and opioid pain medications do but they do so more slowly or less strongly than other opioids so they do not produce euphoria in those being treated for OUD. Methadone and buprenorphine are two types of opioid agonists. Opioid antagonists such as naltrexone block the activation of opioid receptors in the brain. They prevent any opioid drug from producing euphoria. Naltrexone has been limited as an ongoing treatment for opioid use disorder due to the drug not being tolerated by patients and patients not taking the medication as prescribed. In 2010 an injectable, long-acting form of naltrexone was approved by the U.S. Food and Drug Administration for use in the treatment of OUD. This form of the drug is preferable for people who don’t have ready access to healthcare or for those who find it difficult to take medications regularly.
Globally, in 2018, more than half of the revenues from OUD drug treatment came from buprenorphine, followed by methadone and naltrexone. In the United States, buprenorphine also had the highest market share followed by methadone and naltrexone, although naltrexone’s share is predicted to surpass methadone by 2026. Buprenorphine was the first medication eligible to be prescribed by certified doctors through the Drug Addiction Treatment Act of 2000. This eliminated the need for patients to visit specialized treatment clinics thereby increasing access to treatment. The Comprehensive Addiction and Recovery Act, signed into law in 2016, expanded eligibility to prescribe buprenorphine-based drugs as part of MAT to qualifying nurse practitioners and physician assistants through October 1, 2021.
In 2018, the North American market generated the highest revenues and is expected to do the same through 2026 due to the opioid epidemic in the United States and Canada. Also, newer forms of medication to treat OUD are expected to come on the market in the United States during this time period. Several pharmaceutical manufacturers are leaders in this industry including Indivior, Alkermes, Titan Pharmaceuticals, Hikma Pharmaceuticals, Teva Pharmaceuticals, MediciNova, Orexo, Camurus, and Omeros. To increase market share companies are focusing on mergers and acquisitions in addition to launching their products in different regions of the world.
Year: 2018 and 2026
Market size: $1.9 billion and $4.5 billion, respectively
Sources: “Opioid Use Disorder Market Size, Share & Trends Analysis Report by Drug (Buprenorphine, Methadone, Naltrexone), Competitive Landscape, and Segment Forecasts, 2019 – 2026,” Grand View Research Report Summary, July 2019 available online here; “Opioid Use Disorder Market Worth $4.5 Billion By 2026 | CAGR 10.1%,” Grand View Research Press Release, July 2019 available online here; Report of the International Narcotics Control Board for 2019, International Narcotics Control Board, January 2020 available online here; Andrew Saxon, MD, “Opioid Use Disorder,” American Psychiatric Association, November 2018 available online here; University of Southern California. “Teens Abusing Painkillers are More Likely to Later Use Heroin,” ScienceDaily, July 8, 2019 available online here; “Prescription Opioids,” Drug Facts, National Institute on Drug Abuse, July 2019 available online here; “Medications to Treat Opioid Use Disorder,” National Institute on Drug Abuse, June 2018 available online here.
Image source: Hal Gatewood, “Meds,” Unsplash, November 15, 2019 available online here.