A new Avalere report, titled “Understanding the US Opioid Analgesic Market,” aggregates publicly available data on the number opioid analgesic (pain reliever) prescriptions, the types of opioid analgesics dispensed, overdose deaths involving opioids, and public policy and public health initiatives related to opioids.

Trends in Opioids Analgesics Prescribed

Information on the number and types of prescription opioids dispensed annually shows that the total number of prescriptions for opioid analgesic is falling after peaking in 2012 (Figure 1).

The report also presents data on the types of opioid analgesics dispensed, showing that generic opioid analgesics make up the vast majority of the market. Immediate-release (IR) formulations are shown to dominate the market, rather than extended-release (ER) formulations (Figure 2). Most IR opioid analgesics have a comparatively quick onset and short duration, while ER opioid analgesics are designed to prolong opioid release to lengthen dosing intervals.

In response to the potential misuse or abuse of opioids analgesics, some manufacturers have started to develop opioid formulations that, according to the FDA, “target the known or expected routes of abuse, such as crushing in order to snort or dissolving in order to inject.” Opioids analgesics with abuse-deterrence labeling currently represent 2% of the market (Figure 3). To date, there are no generic opioid analgesics with FDA-approved abuse-deterrent labeling.

Trends in Opioid Abuse and Misuse

Despite some decline in opioid analgesic prescriptions, the number of deaths due to opioid overdose continues to rise. As illustrated in Figure 4, deaths associated with synthetic opioids (e.g., fentanyl) and heroin have increased rapidly since 2010, driving overall opioid overdose trends. By contrast, deaths associated with natural opioids like morphine and codeine and semi-synthetic opioids like oxycodone and hydrocodone have remained relatively constant over the same period.

Avalere’s report also compiles a list of key public policy and public health initiatives related to opioid analgesics since 2000.

Methodology

Avalere used data from QuintilesIMS (formerly IMS Health) to analyze annual prescription volume, prescription types, and the number of patients receiving one or more opioid analgesics by prescription in each calendar year. Avalere excluded opioid drug products that are indicated for use in the treatment of opioid addiction (e.g., specific formulations containing methadone or buprenorphine).

The opioid analgesic market was defined as all solid oral dosage forms, whether immediate-release, extended-release, long-acting, single-entity, or combination products; all oral liquid opioid analgesics; and all transdermal (patch) opioid dosage forms. This market definition excludes opioid analgesics in transmucosal, injectable, intranasal, and suppository formulations; as well as opioids with indications for uses other than as analgesics.

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Purdue Pharma L.P. provided funding and content review for this report. Avalere Health maintained full editorial control.