Pain is a multifaceted, highly heterogeneous disorder that is treated using analgesics. There is a lack of diversity within the current pain market, with non-steroidal anti-inflammatory drugs (NSAIDs) and opioids dominating the market. Further, when looking at globally approved drugs for pain indications excluding migraine, 98% are generics. As such, the pain market provides significant opportunities for innovation and development.
Although opioids provide highly effective acute analgesia, they are associated with substantial risks of addiction, respiratory depression, and fatal overdose. Further, as patients develop tolerance to opioids, dose escalation is required to maintain therapeutic effect, resulting in their limited effectiveness for managing chronic pain. Therefore, the most important unmet need in the pain market, consistently highlighted by key opinion leaders (KOLs) interviewed by GlobalData, is the need for non-addictive alternatives to opioids. The recent approval of Vertex Pharmaceuticals’ Journavx (suzetrigine), a NaV1.8 voltage-gated sodium channel inhibitor, for moderate-to-severe acute pain in adults has provided a key breakthrough as the first new class of pain medicine to be approved in more than 20 years. However, KOLs agreed that while Journavx is a welcome non-addictive pain management option, it is not as effective at providing pain relief as they would like to see, especially when compared to opioids. Therefore, as pain is such a heterogeneous indication, significant opportunities remain for a variety of different and more effective non-opioid treatment options to be developed.
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One of the most significant R&D trends in pain treatment is the emergence of voltage-gated sodium channel inhibitors as a validated therapeutic modality for pain relief, providing an alternative to opioids, with many developers other than Vertex pursuing this as a key target. However, there are numerous other novel targets also being investigated by developers to differentiate themselves in the pain market. As of January 2026, 590 drugs were in development globally for pain indications (excluding drugs in development for migraine only), with 32% in late-stage development (Phase II, Phase III, pre-registration), and only 28 drugs targeting the mu opioid receptor. Examples of drugs in late-stage development with novel targets include: Tris Pharma’s dual NOP/MOP receptor agonist cebranopadol in development for moderate-to-severe acute pain, Lexicon Pharmaceuticals’ AP2-associated protein kinase 1 inhibitor pilavapadin in development for diabetic peripheral neuropathic pain, and Vertanical’s cannabinoid 1 and 2 receptor agonist dronabinol in development for chronic low back pain.
As well as novel targets, developers are also looking to novel modalities beyond oral small molecules, such as cell and gene therapies, to provide more targeted and long-lasting pain management. According to GlobalData’s drugs database, as of January 2026, 39% of the global pain pipeline consists of molecule types other than small molecules. Outside of pharmacological developments, other trends in the pain market include the development of neuromodulation techniques, as well as the use of digital therapeutics and wearable devices to improve pain management.
While opportunities exist, there are multiple challenges surrounding drug development in the pain market. Firstly, pain is inherently subjective, making it challenging to objectively determine a drug’s efficacy in a clinical trial. Pain trials are also associated with high placebo response rates, further increasing the challenge of demonstrating efficacy. Additionally, chronic pain is highly heterogenous with many patients experiencing a mixture of different pain types, making patient stratification for clinical trials a challenge. However, regulatory incentives to develop non-opioid pain candidates, and innovation in trial designs, such as master protocol platform trials that allow multiple novel compounds to be evaluated across multiple pain types simultaneously, reducing development times and costs, mean significant interest remains in the pain market. GlobalData’s recent report ‘Market & Modality Trends: Global Pain Therapeutics Market’ explores the opportunities and challenges in the pain market in depth.
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