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Opioids Crisis – Public Health Emergency

Opioids are the class of drugs that include illicit drugs such as heroin, codeine, fentanyl, meperidine, methadone, morphine, hydrocodone, diphenoxylate, hydromorphone, methylphenidate, oxycodone, and oxymorphone. Opioids are prescribed for pain management and treatment of cough and diarrhea. According to the survey conducted by Center for Behavioral Health Statistics and Quality (CBHSQ), in 2015, out of 20.5 million around 2 million (10%) Americans of 12 years age or older, which had a substance use disorder were on pain relievers and around 591,000 were on heroin.

Crisis in the U.S. Opioids Market

According to the New York Times analysis of state data, in 2016, drug overuse led to death of 59,000 to 65,000 people in the U.S. Around two-third of these deaths were due to opioids overuse and the number is expected to increase. According to a survey of National Institute of Drug Abuse (NIDA), deaths due to the overdose prescription of opioid pain relievers have more than tripled in the past 20 years, escalating to 16,651 deaths in the U.S. in 2010. It can be concluded from the analysis of the data (data from the survey and New York Times data), that death due to opioids have more than doubled in the past six years.

In October 2016, the U.S. government declared opioids crisis as an emergency to increase awareness among the public about overuse of opioids. The crisis also restricts doctors and pharmacy stores from over-prescribing or overstocking opioids. Furthermore, the government has approached leading pharmacy chains, insurance companies, and others for cooperation against opioid crisis. For instance, Attorney General of over 35 states sent a letter to the America’s Health Insurance Plans, national association whose members provide coverage for health care and related services, urging its members to reconsider coverage policies that may be fueling the opioid crisis in October 2017. Such measures can ensure proper usage of opioids and favor the market players in the U.S.

The U.S. opioids market was valued at US$ 12,046.3 million in 2015 and is expected to witness a moderate CAGR of 5.2% during the forecast period (2016–2024).

Figure 1. U.S. Opioids Market Size and Forecast, By Drugs (US$ Million), 2014–2024

SOURCE: COHERENT MARKET INSIGHTS ANALYSIS, 2017

Increasing incidences of chronic pain is expected to drive growth of the U.S. opioids market

According to the American Academy of Pain Medicine (AAPM), 2011, around 1.8 billion people suffered from chronic pain. Moreover, according to the National Institute of Health (NIH) estimates in 2015, one in 10 people in the U.S. suffered from chronic pain. Increasing prevalence of chronic pain is expected to result in high prescription of opioids pain relievers, which in turn is expected to fuel the market growth. Easy availability and favorable insurance policy are other major drivers for growth of the U.S. opioids market.

The analysis of Medicare prescription drug plans, which covers 35.7 million people in the second quarter of 2017, by ProPublica — an investigative journal and The New York Times — a leading U.S. newspaper, revealed that only one-third of the covered people had any access to other types of pain killer and less-risky opioids. This was attributed to low cost of opioids drugs. The scenario might change, however, due to strict monitoring from government and regulatory bodies.

Cannabis as potential alternative for pain relief can be a threat to the U.S. opioids market

Cannabis could be the alternative therapy for opioids. Currently, medical marijuana is legal in 28 states and the District of Columbia even though it is illegal under federal law. According to a research published in Annals of Internal Medicine, in majority of cases, between 45% and 85%, medical marijuana is used for pain management. However, there is some ambiguity about medical marijuana effectiveness in pain management. Cannabis could be used as effective therapy after establishment of clinical trials.

Some major players operating in the U.S. opioids market include Purdue Pharma L.P., Titan Pharmaceuticals, Inc., Boehringer Ingelheim GmbH, Janssen Pharmaceuticals, Inc., Sanofi S.A., Sun Pharmaceuticals Industries Limited, Mallinckrodt Pharmaceuticals, Egalet Corporation, Endo Pharmaceuticals plc, Allergan, plc, and Pfizer Inc.