The report provides detailed analysis of current and emerging drugs for opioid induced constipation treatment, and the market is estimated based on type of drug class and dosage form of the drugs. Drug classes include mu-opioid receptor antagonist, chloride channel activator, and others based on their mechanism of action. Based on dosage form of drugs, the market has been segmented into solid, semi-solid, and liquid.

The chloride channel activator segment accounted for the largest share of the opioid induced constipation treatment market in 2014 due to first approval and launch of Amitiza in major countries. However, mu-opioid receptor antagonist was the fastest growing segment due to recent launch of the new drug Movantik and presence of pipeline drugs (naldemedine and other early stage drugs). Mu-opioid receptor antagonist drugs target the root cause of constipation by acting on specific peripheral opioid receptors, which revert the opioid action without affecting opioids analgesic action. Presently, Amitiza is the only available drug that belongs to the chloride channel activator class.

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However, mu-opioid receptor antagonist class consists of Movantik (AstraZeneca), Relistor (Valeant Pharmaceuticals, Inc.), and Naloxone. Additionally, naldemedine is in the late stage clinical trial. The drug is investigational, oral, mu-opioid receptor antagonist and is expected to launch in mid-2016. In August 2015, Shionogi’s naldemedine met primary and secondary endpoints in phase III clinical trial (COMPOSE II) to treat opioid induced constipation.

Linaclotide is another potential drug, which is currently in phase II clinical trial. Phase I clinical trial (KODIAK16) is underway to assess the efficacy and safety of naloxegol in the treatment of opioid induced constipation in pediatric patients. The trial is expected to be completed in November 2017. Hence, launch of pipeline drugs during the forecast period is expected to boost the growth the PAMORA segment. The others segment includes Resolor (prucalopride), bulking agents (cellulose and psyllium), stool softeners (docusate), laxatives, and osmotic agents (lactulose, sorbitol, and polyethylene glycol).

Major players in this segment are Boehringer Ingelheim GmbH and C.B. Fleet Company, Inc. Traditional laxatives are not legally approved for the treatment of opioid induced constipation. However, low cost of therapy, high awareness, and easy access to medicines accounted significant share of the opioid induced constipation treatment market. For instance, monthly cost of standard laxative therapy ranges from US$ 6 to US$ 80.

However, monthly cost of Amitiza ranges from US$ 300 to US$ 400 and from US$ 600 to US$ 1000 for Relistor. Asia Pacific, Latin America, and Middle East & Africa are the major consumers of traditional medicines used to treat opioid induced constipation due to easy access, low cost, and less awareness about targeted therapy.

Furthermore, based on dosage form, the market has been segmented into solid, semi-solid, and liquid. The solid dosage form segment accounted for the largest share of the market in 2014. The segment is expected to maintain its leadership position during the forecast period. This is due to high patient compliance and launch of new drugs in solid form such as capsules, tablets, and pills. The semi-solid and liquid dosage form segments accounted for small shares of the market.

The number of players operating in the opioid induced constipation treatment market is small, while demand for the therapy is high. 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.

Acquisitions and collaborations among major companies to commercialize OIC medicines are expected to boost the market during the forecast period. For instance, in March 2015, AstraZeneca and Daiichi Sankyo signed a co-commercialization agreement for Moventik in the U.S. In addition, in October 2014, Takeda and Sucampo entered into global license, development, and commercialization agreement for Amitiza. Hence, strategic agreements between companies are expected to drive the opioid induced constipation treatment market during the forecast period from 2015 to 2023.

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