Commonly used opioids to treat moderate to severe pain are fentanyl, hydromorphone, methadone, morphine, oxycodone, and pethidine. Opioids play an important role in the management of chronic pain by acting on mu opioid receptors in the brain. However, these also bind to mu opioid receptors present in the intestine. Hence, patients taking opioids suffer from severe constipation known as opioid induced constipation (OIC). Chronic severe constipation further affects the lifestyle of patients, hence the need to prescribe adjacent therapy along with opioids to treat chronic constipation. Presently, usage of opioid to treat chronic cancerous and non-cancerous pain is limited to North America, Europe, and Australia due to high acceptance of opioids and increasing health care expenditure. Hence, these are the most attractive markets for opioid induced constipation treatment.
The global opioid induced constipation treatment market has been segmented based on drug class and dosage form of the drugs. Based on drug class, the market has been segmented into mu-opioid receptor antagonists, chloride channel activator, and others. The mu-opioid receptor antagonist segment consists of Moventik (AstraZeneca), Relistor (Valeant), and Naloxone. The chloride channel activator segment includes Amitiza (Takeda) and the others segment includes Resolor and traditional laxatives. Traditional laxatives such as bulking agents, osmotic agents, and stool softeners affect bowel movement. However, the effect is temporary and frequently induces undesired side effects. Hence, the others segment accounted for a small share of the global opioid induced constipation treatment market. The chloride channel activator segment accounted for the highest share of the global opioid induced constipation treatment market owing to high demand for Amitiza as single drug in the market. However, mu-opioid receptor antagonist is the fastest growing segment owing to recent launch of Moventik and presence of pipeline drugs (Naldemedine). Additionally, the class specifically targets peripheral mu-opioid receptors hence revert the action of opioid on peripheral receptors without affecting opioids central analgesics effect. Based on dosage form of the drugs, the market has been segmented into solid, semi-solid, and liquid. Major medicines for opioid induced constipation are available in the solid dosage form such as pills, tablets, and capsules. Hence, the solid dosage form segment accounted for the largest share of the market in 2014. The segment is anticipated to dominate the market during the forecast period. This is due to high patient compliance and less painful procedure than parenteral route. Liquid dosage form consists of emulsions, suspensions, syrups, and subcutaneous injections. The segment is expected to witness moderate growth during the forecast period.
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Geographically, the opioid induced constipation treatment market has been classified into five major regions: North America, Europe, Asia Pacific, Latin America, and Rest of the World. North America accounted for the largest share of the market in 2014 and is expected to gain market share during the forecast period from 2015–2023. This is due to increase in the number of opioid induced constipation sufferers, approval and launch of drugs to treat OIC, availability of pipeline drugs, and favorable government initiatives. However, the market is witnessing slow growth in Asia Pacific, Latin America, and Rest of the World owing to low awareness about opioid induced constipation treatment, high cost of the therapy, and less penetration of opioid to treat chronic pain. Amendments in regulations in some countries over opioid use and patient-physician awareness are the major factors likely to increase uptake of opioid induced constipation medicines in Asia Pacific, Latin America, and Rest of the World.
The opioid induced constipation treatment market exhibits intense competition among the existing players. The players operating in the market are limited; however, a number of companies are interested to invest in the market due to increasing demand for the therapy. Major players operating in the global opioid induced constipation treatment market are AstraZeneca plc, Takeda Pharmaceutical Company Limited, Abbott Laboratories, Valeant Pharmaceuticals International, Inc., Bayer AG, C.B. Fleet Company, Inc., Boehringer Ingelheim GmbH, Daewoong Co. Ltd., and Cosmo Pharmaceuticals.