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Huge Market Belies The Long And Difficult Road To Novel Pain Therapies

Executive Summary

Since the introduction of the first triptan for aborting migraine in 1992, no truly new class of pain drug – other than off-label use of existing anticonvulsants and antidepressants for neuropathic pain – has reached the market. In fact, the vast majority of pain sufferers today are treated little differently than they would have been a century ago.

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The 2013 Dr. Paul Janssen Awards honored UCSF’s David Julius for his work in pain, but both science and industry admits pain drug development is suffering due to the complexity and cost of the research.

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Nothing has arguably hurt pharmaceutical investors and dealmakers quite so often and with such force as novel pain drug development failures. As a result, a once hot field has gone cold. Despite setbacks, great strides have been made in understanding the complex biology of pain. Scientists have discovered numerous new pain pathway targets with the potential for designing effective agents with fewer off-target effects. Improvements that make preclinical studies more predictive of clinical success are also opening up new opportunities. At the same time, drug developers now understand better how to design drug trials that can segment patient populations to demonstrate therapeutic efficacy more precisely, potentially reducing placebo effects and paving the way for an era of personalized pain medicine.

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