NEW YORK, Dec. 17, 2012 /PRNewswire/ -- Reportlinker.com announces that a new market research report is available in its catalogue:

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Prescribing trends reveal that patients with PHN are typically initiated on monotherapy. Since no single therapy provides sufficient efficacy, physicians increasingly turn to combination therapy at later lines of treatment to optimize patient outcomes. Lyrica (pregabalin; Pfizer) leads the market, with the recent market entrant Gralise (extended-release gabapentin) struggling to make an impact.Gain insight into patient presentation, diagnosis, and treatment rates and understand which physician types are responsible for management of PHN.Quantify the PHN population across the seven major markets by pain severity (mild, moderate, and severe).Understand which drug treatments are the most commonly prescribed and how this differs across line of therapy and geographic region.Analyze the class, formulation, and brand prescribing trends in the seven major markets.Understand the response rate of patients across three lines of therapy and rates of progression from first to second and third lines of therapy.Following first-line therapy, combination therapies become the mainstay of treatment regimens for the management of PHN, as physicians attempt to optimize therapeutic outcomes. Therefore positioning treatments as adjuvant therapy represents a key opportunity for drug developers.With the vast majority of patients prescribed anticonvulsants as first-line therapy, this treatment class represents the key competition to prospective market entrants. Widespread, off-label prescribing of antidepressants also represents a significant competitive barrier within the PHN market.Lyrica (pregabalin; Pfizer) is the leading brand in the PHN market. Generally, branded products are well received in the market, accounting for the majority of treatments prescribed at first-line therapy.What drugs are the most commonly prescribed for the management of PHN in each of the seven major markets?What are the current PHN market dynamics and the competitive landscape in terms of patient numbers?How can drug developers optimize patient share and position new products appropriately within the PHN market?Which physician types are primarily responsible for PHN prescribing decisions and are therefore key targets for marketing efforts for PHN treatments?What proportion of patients responds to first-line therapy and what proportion progress to second and third lines of therapy?

Summary

Datamonitor key findings

COUNTRY TREATMENT TREES

Introduction to treatment trees

Seven major markets

US

Japan

France

Germany

Italy

Spain

UK

DISEASE DEFINITION AND DIAGNOSIS

Disease definition

Etiology

Postherpetic neuralgia results from nerve damage caused by the herpes zoster virus

There are three key points of influence in the prevention of postherpetic neuralgia

Symptoms

Presentation and diagnosis

Less than two thirds of individuals with symptoms of postherpetic neuralgia present to a physician

Of individuals presenting to physicians with symptoms of PHN, 58% receive a diagnosis of PHN

Treatment rates

Across the seven major markets, 37% of diagnosed PHN patients do not receive pharmacological treatment

Influences on diagnosis and treatment rates

Identification of patients at risk of developing PHN is key to capturing the potential treatment market

Referral patterns

Patients with PHN are predominantly managed by primary care physicians/general practitioners

PATIENT SEGMENTATION

Severity of postherpetic neuralgia

The majority of patients with postherpetic neuralgia suffer from moderate to severe pain

Symptoms associated with pain in PHN

Burning sensation, shooting pain, and interrupted sleep are the key pain-associated symptoms in PHN

CURRENT TREATMENT OPTIONS

Overview of drug classes

Only five patented products are indicated for the treatment of postherpetic neuralgia

Anticonvulsants

Antidepressants

Opioids

Topical treatments

PRESCRIBING TRENDS

Class trends

Anticonvulsants are the most commonly prescribed drug class for PHN across all lines of therapy

Across the seven major markets antidepressants are frequently prescribed off-label for PHN

The US has the highest level of opioid prescribing for postherpetic neuralgia

Poor perception of efficacy leaves local anesthetics as the fourth most frequently prescribed drug class

Anxiolytic and antiarrhythmic treatments are not widely prescribed for the management of PHN

Formulation trends

Oral treatments dominate the treatment of postherpetic neuralgia at all lines of therapy

Combination therapy trends

Combination therapy is the mainstay at second and third-line therapy in order to optimize patient outcomes

Prescribing of brands versus generics

Branded products are favored for the first-line management of PHN

Changes in therapy

Lyrica monotherapy dominates the market as the top therapeutic option across all lines of therapy

Lyrica continues to dominate at second-line therapy

Treatments struggle to dominate later lines of therapy amid a vast range of different therapeutic options

Lidoderm and Lyrica provide models of successful PHN treatments in the US market

Patients with PHN increasingly spend longer on second and third-line therapy

Treatment outcomes

Response to therapy

Progression through lines of therapy

Compliance to therapy

BIBLIOGRAPHY

Journal papers

Websites

APPENDIX A

Physician research methodology

Physician sample breakdown

The survey questionnaire

Screener

APPENDIX B

Contributing experts

Conferences attended

Table: Summary of drug classes and molecules used for the treatment of postherpetic neuralgia, 2012

Table: The proportion of patients across the seven major markets receiving monotherapy or combination therapy, across different lines of therapy, in the seven major markets, 2012

Table: The top 20 first-line treatments for postherpetic neuralgia across the seven major markets and the proportion of patients receiving these therapies in the individual markets, 2012

Table: The top 20 second-line treatments for postherpetic neuralgia across the seven major markets and the proportion of patients receiving these therapies in the individual markets, 2012

Table: The top 20 third-line treatments for postherpetic neuralgia across the seven major markets and the proportion of patients receiving these therapies in the individual markets, 2012

Table: Treatment response among patients with postherpetic neuralgia across the seven major markets, 2012

Table: Physicians surveyed regarding neuropathic pain across the seven major markets, 2012

Figure: Postherpetic neuropathic pain treatment algorithm in the US, 2012

Figure: Postherpetic neuropathic pain treatment algorithm in Japan, 2012

Figure: Postherpetic neuropathic pain treatment algorithm in France, 2012

Figure: Postherpetic neuropathic pain treatment algorithm in Germany, 2012

Figure: Postherpetic neuropathic pain treatment algorithm in Italy, 2012

Figure: Postherpetic neuropathic pain treatment algorithm in Spain, 2012

Figure: Postherpetic neuropathic pain treatment algorithm in the UK, 2012

Figure: Etiology of postherpetic neuralgia

Figure: Common sites for shingles and subsequent postherpetic neuralgia

Figure: Percentage of individuals with the symptoms of postherpetic neuralgia presenting to physicians, 2012

Figure: The diagnosis rate of individuals presenting to physicians with the symptoms of postherpetic neuralgia, 2012

Figure: The percentage of patients diagnosed with postherpetic neuralgia receiving pharmacological treatment, 2012

Figure: A screenshot of patient-centric educational material regarding postherpetic neuralgia, produced by Depomed, 2011

Figure: Percentage of postherpetic neuralgia patients across the seven major markets who are managed by different healthcare professionals during patient presentation, diagnosis, treatment, and management, 2012

Figure: Patient segmentation by severity of postherpetic neuralgia pain, across the seven major markets, 2012

Figure: Percentage of patients experiencing pain associated with the symptoms of postherpetic neuralgia, 2012

Figure: The impact of postherpetic neuralgia symptoms on patients, as rated by surveyed physicians, 2012

Figure: Proportion of patients with postherpetic neuralgia receiving different classes of therapy at three lines of therapy, across the seven major markets, 2012

Figure: The percentage of patients receiving each drug class as first-line therapy across the seven major markets, 2012

Figure: The relative proportion of therapies, by formulation, that patients are prescribed for the management of postherpetic neuralgia, 2012

Figure: The percentage of patients with postherpetic neuralgia receiving combination or monotherapy across different lines of therapy, in the seven major markets, 2012

Figure: The relative proportion of branded versus generic products prescribed for the first-line management of postherpetic neuralgia across the seven major markets, 2012

Figure: The relative percentage of branded or generic drug therapies prescribed to patients in the seven major markets, Spain, and the UK, 2012

Figure: The percentage of patients receiving branded products as first-line therapy, by drug class, across the seven major markets, 2012

Figure: The top 10 first-line treatments for postherpetic neuralgia across the seven major markets and the proportion of patients receiving these therapies in the individual markets, 2012

Figure: The top 10 second-line treatments for postherpetic neuralgia across the seven major markets and the proportion of patients receiving these therapies in the individual markets, 2012

Figure: The top 10 third-line treatments for postherpetic neuralgia across the seven major markets and the proportion of patients receiving these therapies in the individual markets, 2012

Figure: The proportion of patients receiving key FDA-approved therapies, either as monotherapy or combination therapy, for the management of postherpetic neuralgia, across all lines of therapy in the US, 2012

Figure: The mean number of weeks patients with postherpetic neuralgia spend on first, second, and third-line therapy, across the seven major markets, 2012

Figure: Percentage of postherpetic neuralgia patients responding to first-line therapy across the seven major markets, 2012

Figure: The percentage of patients who progress through three lines of pharmacotherapy across the seven major markets, 2012

Figure: Mean compliance rate across the seven major markets, by type of therapeutic regimen, 2012

Figure: Reasons for patients' non-compliance to therapy in neuropathic pain, 2012

Figure: First-line treatment of postherpetic neuralgia

Figure: Second-line treatment of postherpetic neuralgia

Figure: Third-line treatment of postherpetic neuralgia

Choices, Devoteam SA, GlaxoSmithKline Plc, Hutchison 3G UK Limited, Schindler Holding Ltd.

To order this report:Therapy Industry: Treatment Algorithms: Postherpetic Neuralgia – Lyrica forms the cornerstone of treatment for postherpetic neuralgia

Nicolas Bombourg

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Email: nicolasbombourg@reportlinker.com

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