Feeling No Pain

Endo is nicely poised to grab a big piece of the rapidly expanding pain-management market.
Nov 01, 2004

Carol Ammon, CEO of Endo Pharmaceuticals, received the 2003 Greater Philadelphia Ernst & Young Entrepreneur of the Year Award.
Our goal when we started this company was to reach the point that when people think about pain management, they think of Endo," says CEO Carol Ammon.

If the company is not quite there, it should be very soon. Last year, Pennsylvania-based Endo Pharmaceuticals, maker of both brands and generics, experienced a 49 percent growth in sales—from $399 million to $596 million. Much of that jump came from Lidoderm, a lidocaine patch whose sales more than doubled and which analysts see as the company's most significant future growth driver. The product is indicated for post-herpetic neuralgia (neuropathic pain), a rapidly growing market in which Endo already has a 26 percent share. With two new launches and three products under FDA review, the company is also poised to grab a big piece of the chronic pain market. The greatest gains will come from Endo's:

  • generic versions of extended-release oxycodone, which will cut into Purdue's $1.9 billion in annual revenue from OxyContin
  • generic fentanyl patch, which will grab some of J&J's $1.3 billion in sales for Duragesic.

But Endo isn't relying only on short-term gains from generic copies of blockbusters. It also has a deep pipeline of patent-protected, in-licensed products and development deals that are setting it up for long-term stability in a global pain-management market that's expected to expand greatly as the population ages.

Topical lidocaine’s mechanism of action is to stabilize neuronal activity linked with Na+ channel accumulation, which reduces pain signal initiation and transmission. The patch acts locally on damaged peripheral nerve and soft tissue, but does not cause complete sensory block in the area of application.
Mentality Shift Most of those aging consumers will be US baby boomers, who are much less inclined than their Depression-era parents to be stoics about pain. "In the old school thinking, patients wanted to please their physicians," Ammon says. "They were willing to say they were okay when they were not." In the last ten years, there has been a vast change in that attitude, much of it a result of patient education—through the internet, direct-to-consumer advertising, and outreach efforts from patient groups and companies like Endo.

"We are not yet where we need to be, but there is a much better understanding of the need to aggressively treat pain," Ammon says. "There is now a whole specialty in the area of pain management, which was added in the early 1990s. Physicians have the opportunity to take their residency in pain management. And in the past, hospitals were never assessed on how well they were treating pain. Now all the new accreditation standards rate hospitals on how effectively they are assessing and treating pain. Every patient visit now must be accompanied by an assessment of the patient's pain. Patients are asked how they feel, on a scale of zero to ten. That has to be monitored and logged in their patient forms."

This shift in the mentality of treating pain has driven the market into new territory, both in terms of revenue and products. According to Visiongain, the global pain-management market is expected to grow at an annual rate of 4.7 percent and will hit $29.7 billion in 2007. Patient convenience and compliance are also driving technology-based pharmas to develop novel delivery mechanisms. In fact, most of the compounds prescribed to treat pain have been around for decades, and the competitive edge in this market goes to companies that find novel formulations that are easy for patients to use.

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