Chronic Refractory Cough Market Summary

• The Chronic Refractory Cough Market Size in the seven major markets was over USD 8,800 million in 2023, which is further expected to increase by 2034 at a significant Compound Annual Growth Rate (CAGR) for the study period (2020–2034).
• The United States accounts for the largest Chronic Refractory Cough Market Size, in comparison to the EU4 (Germany, Italy, France, Spain) and the United Kingdom, and Japan, accounting for nearly USD 4,500 million in 2023.

Chronic Refractory Cough Market and Epidemiology Analysis

• In the 7MM, females exhibit a higher Chronic Refractory Cough Prevalence compared to males, possibly due to hormonal influences, differences in airway sensitivity, and variances in healthcare-seeking behavior.
• GSK plc has acquired BELLUS Health Inc. for approximately USD 2.0 billion (EUR 1.6 billion), gaining access to camlipixant (BLU-5937), a highly selective P2X3 antagonist in Phase III development for refractory chronic cough (RCC). With anticipated regulatory approval and launch in 2026, this acquisition strengthens GSK's respiratory pipeline and underscores its commitment to advancing innovative treatments for chronic cough.
• Neuro-modulating agents held the largest market share, around 80%, in 2023. However, by the end of the forecast period, a slight decrease in their market share is expected due to the introduction of more effective novel therapies.
• The Chronic Refractory Cough Treatment Market is expected to grow during 2024-2034 due to increased awareness, an aging population, advancements in diagnosis and treatment, and rising healthcare expenditure, alongside technological innovations and anticipated regulatory approvals for novel therapies.

Chronic Refractory Cough Market Size and Forecasts

• 2023 Chronic Refractory Cough Market Size: USD 8,800 Million
• 2023 USA Chronic Refractory Cough Market Size: USD 4,500 Million
• 2023 Japan Chronic Refractory Cough Market Size: USD 1,100 million
• Largest Chronic Refractory Cough Market: United States
• Market Structure: Moderately Consolidated

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Factors affecting Chronic Refractory Cough Market Growth:

Rising Chronic Refractory Cough Prevalence

The US accounted for approximately 13 million 12-month prevalent cases of chronic cough in 2024. These numbers are anticipated to rise by 2034, driven by the aging population that has an increased likelihood of developing chronic conditions such as asthma, COPD, and chronic cough.

Advancements in Diagnostics

New diagnostic techniques, such as cough reflex sensitivity testing, high‑resolution computed tomography (HRCT), and improved clinical protocols, improve the precision of diagnosis for refractory cough. Better diagnosis helps in tailored therapy, which in turn supports the adoption of specialized treatments.

Launch of Emerging Chronic Refractory Cough Drugs

The introduction of new therapies, including camlipixant (GSK), haduvio (nalbuphine ER) (Trevi Therapeutics), Taplucainium (Nocion Therapeutics), and others, is anticipated to further bolster the market throughout the forecast period (2025–2034).

DelveInsight’s report titled “Chronic Refractory Cough Market Insights, Epidemiology, and Market Forecast – 2034” comprehensively analyzes Chronic Refractory Cough. The Chronic Refractory Cough Treatment Market Report provides a comprehensive analysis of historical and projected epidemiological data, covering 12-month Prevalent Cases of Chronic Cough (CC), Gender-specific Cases of Chronic Cough (CC), Total Diagnosed Prevalent Cases of Chronic Refractory Cough, and Diagnosed Prevalent Cases of Chronic Cough in Idiopathic Pulmonary Fibrosis (IPF).

The Chronic Refractory Cough Treatment Market Report provides a comprehensive insight into different facets concerning the patient population, encompassing diagnosis, prescribing trends, physician viewpoints, market accessibility, therapy, and forthcoming market advancements across seven major markets: the United States, EU4 (Germany, France, Italy, andSpain), the UK, and Japan spanning from 2020 to 2034. The Chronic Refractory Cough Treatment Market Rreport examines current treatment methodologies and algorithms for Chronic Refractory Cough, assessing the overall market potential, identifying business prospects, and addressing pertinent unmet medical requirements.

Chronic Refractory Cough Treatment Market

Chronic Refractory Cough persists for over 8 weeks despite treatment, affecting individuals across medical specialties and significantly impacting their quality of life. It often stems from conditions like laryngopharyngeal reflux (LPR), obstructive sleep apnea, or medication side effects like ACE inhibitors. CRC shares symptoms with chronic cough (CC), including persistent dry cough and respiratory discomfort, leading to psychological, social, and physical challenges. Women are more prone to CC, experiencing interruptions in daily life due to social embarrassment and physical exhaustion from frequent coughing.

CRC presents a formidable challenge for patients, characterized by its nonproductive nature often preceded by viral respiratory infections. It usually starts with a dry cough that does not produce any phlegm, often after a viral illness. People with CRC often describe it as a persistent, irritating cough that feels like it is coming from their throat. This cough can really disrupt the daily life and make things tough. Unfortunately, in many situations, patients continue to experience CRC despite following the published guidelines for diagnosis and treatment.

Chronic Refractory Cough Diagnosis and Treatment Algorithm

Diagnosing Chronic Refractory Cough involves a two-tiered approach, starting with a primary assessment to rule out common causes of chronic cough and identify potential alarm symptoms. Subsequently, a secondary assessment, including nasendoscopy and pH monitoring, helps characterize the condition further. However, limitations exist in both phases, as primary assessment may overlook specific underlying causes, while secondary tests may not always yield definitive results, leading to potential diagnostic challenges and delays in treatment initiation.

Treatment of CRC encompasses a spectrum of nonpharmacologic and pharmacologic interventions. Nonpharmacologic therapies like Speech Therapy and Physiotherapy play a crucial role in addressing cough characteristics and laryngeal abnormalities, albeit with potential limitations related to treatment duration and patient compliance. Pharmacologic options, including neuromodulators and proton pump inhibitors, offer additional avenues for management, yet their efficacy may vary, and access to newer treatments such as gefapixant may be restricted. Collaborative decision-making, considering the efficacy and limitations of available therapies, remains paramount in optimizing outcomes for patients with CRC.

Chronic Refractory Cough Epidemiology

The epidemiology section on Chronic Refractory Cough offers an analysis of past and present patient populations, along with projected trends across seven major countries (7MM). Drawing from multiple studies and expert opinions, it aims to elucidate the underlying factors driving current and anticipated trends. Additionally, this segment of the report presents data on the Chronic Refractory Cough diagnosed patient population, highlighting trends and underlying assumptions.

Key Findings from the Chronic Refractory Cough Epidemiology Report

• In 2023, the 12-month prevalent cases of CC were estimated to be around 30 million cases in the 7MM. These cases are expected to increase by 2034 at a significant CAGR.
• Among the 7MM, the United States accounted for nearly 42% of the 12-month prevalent cases of CC with over 12 million cases in 2023 which are expected to increase further by 2034.
• According to assessments conducted by DelveInsight's analysts, it was estimated that more than 12 million cases represented the total diagnosed prevalent cases of CRC across the 7MM in 2023. Within the 7MM, the United States recorded the highest number of diagnosed prevalent cases of CRC in 2023, followed by Japan. The prevalent population for CRC was determined based on the patient pool of CC.
• In the US, gender-specific cases of CC in 2023 were comprised of approximately 40% males and 60% females, with projections indicating an increase by the year 2034.
• Among the European Countries, Germany accounted for the highest number of total diagnosed prevalent cases of CRC (1.3 million cases), followed by the UK (1 million) cases in 2023. In contrast, Spain accounted for the least of the total diagnosed prevalent cases of CRC in the EU4 and the UK.
• In 2023, Japan accounted the second-highest number of diagnosed prevalent CRC cases, totaling 1.8 million, representing approximately 15% of the total diagnosed prevalent cases of CRC across the 7MM. Projections suggest a decrease in these cases by the year 2034.
• In the US, the diagnosed prevalent cases of CC in IPF were around 76 thousand cases in 2023 which are expected to increase by 2034.

Chronic Refractory Cough Epidemiology Segmentation

• 12 month Prevalent Cases of Chronic Coughs in the 7MM
• Gender-specific Cases of Chronic Coughs in the 7MM
• Total Diagnosed Prevalent Cases of Chronic Refractory Coughs in the 7MM
• Diagnosed Prevalent Cases of Chronic Coughs in ILD in the 7MM

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Chronic Refractory Cough Drug Analysis

The drug chapter segment of the Chronic Refractory Cough drugs market report encloses the detailed analysis of Chronic Refractory Cough marketed drugs, mid-phase, and late-stage pipeline drugs. It also helps to understand the Chronic Refractory Cough clinical trials details, expressive pharmacological action, agreements and collaborations, approval, and patent details of each included drug, and the latest Chronic Refractory Cough news and press releases.

Chronic Refractory Cough Marketed Therapies

Currently, there are no FDA approved therapies available to treat CRC. The latest guidelines from the American College of Chest Physicians (ACCP) outline four treatment categories: non-pharmacologic therapies, inhaled corticosteroids (ICS), neuromodulatory therapies, proton pump inhibitors, and other treatment options.

Chronic Refractory Cough Emerging Therapies

• Gefapixant (MK-7264): Merck & Co/ Kyorin Pharmaceuticals

MK-7264 (gefapixant), being developed by Merck is a selective, non-narcotic, orally administered P2X3 antagonist designed to target the mechanism by which certain nerve fibers become hypersensitized and can lead to chronic and debilitating symptoms, such as CC. It is a selective P2X3 receptor antagonist that prevents ATP binding, which has a significant role in the activation of the sensory fibers central to cough initiation. Thus MK‐7264 exerts its antagonism via negative allosteric modulation. In January 2022, the Japan MHLW approved LYFNUA (gefapixant) for the treatment of adults with RCC or UCC. However, the US FDA has issued a CRL regarding Merck’s NDA for MK-7264 and requested additional information related to the measurement of efficacy.

• Camlipixant (BLU-5937): Bellus Health- a GSK company

Camlipixant (formerly known as BLU-5937), being developed by Bellus Health- a GSK company, is a potent, highly selective, oral antagonist of the P2X3 receptor, a clinically validated target for CC. BLU-5937 has the potential to be a best-in-class therapeutic for CRC patients, as it has shown to be highly selective (>1500-fold) for human P2X3 receptors versus P2X2/3 receptors. Bellus Health has completed Phase IIb (SOOTHE) trials and is currently being investigated in Phase III trials.

Chronic Refractory Cough Market Outlook

The Chronic Refractory Cough market currently faces a significant challenge with the absence of approved therapies, leaving patients with a critical unmet need. Non-pharmacologic interventions, particularly Speech Therapy and Physiotherapy, represent the cornerstone of current treatment strategies. After nonpharmacological therapies, the market holds various types of pharmacologic therapies which include neuromodulators, proton pump inhibitors, ICS, and other treatment options. Neuromodulators include opiates (morphine, codeine, tramadol, etc.), gabapentin, pregabalin, morphine, amitriptyline, and baclofen, which act on the heightened neural sensitization that is involved in the pathogenesis of CRC.

ICS are effective in eosinophilic airway inflammation. An assessment of airway eosinophilia (induced sputum, bronchoalveolar lavage) or exhaled NO is followed before subjecting patients with ICS in case of CRC. These mainly include mometasone, budesonide, and beclometasone. Treatment with ICS can significantly reduce cough but regress analyses are required to address the exact treatment regimen of these drugs. Combined therapy can also be employed to treat patients with CRC. This includes the use of nonpharmacologic and pharmacologic interventions together, i.e., combining speech therapy with drugs to provide relief to the patients. Patients on speech therapy can be advised to opt for drugs, such as pregabalin or gabapentin. Recently Japan’s MHLW approved Merck’s LYNFUA (gefapixant), an orally-administered, selective P2X3 receptor antagonist for the treatment of adults with RCC or UCC

The market holds a critical unmet need with no approved curative definitive therapy for CRC. The pharmacologic therapies that are employed cannot be used in a long term due to various adverse events associated with them. Expected launch of potential therapies that include orvepitant maleate (Nerre Therapeutics), Camlipixant (BLU-5937) (Bellus Health/ GSK), MK-7264 (gefapixant) (Merck), and others may address this unmet need, increase the market size in the coming years.

Key Findings from the Chronic Refractory Cough Market Report

• The Chronic Refractory Cough Market Size in the seven major markets was over USD 8,800 million in 2023, which is further expected to increase by 2034 at a significant Compound Annual Growth Rate (CAGR) for the study period (2020–2034).
• The United States accounts for the largest Chronic Refractory Cough Market Size, in comparison to the EU4 (Germany, Italy, France, Spain) and the United Kingdom, and Japan, accounting for nearly USD 4,500 million in 2023.
• Germany boasted the largest Chronic Refractory Cough Market Size among European countries, comprising around 26% of the total EU4 and UK market in 2023. Projections suggest this lead will continue to grow, with Germany anticipated to dominate the market, followed closely by the UK, by the year 2034.
• The Chronic Refractory Cough Market Size in Japan was valued at approximately USD 1,100 million in 2023. It is expected that the market will increase mainly due to the launch of upcoming therapy during the forecast period (2024–2034).
• The launch of potential therapies, MK-7264 (gefapixant), Camlipixant (BLU-5937), Orvepitant Maleate, and others is expected to increase the market size in the coming years, assisted by the increase in the diagnosed prevalent population of CRC.

Chronic Refractory Cough Market Segmentation

DelveInsight’s ‘Chronic Refractory Cough Drugs Market Insights, Epidemiology, and Market Forecast – 2034’ report provides a detailed outlook of the current and future Chronic Refractory Cough market, segmented within countries and by therapies. Further, the market of each region is then segmented by each therapy to provide a detailed view of the current and future Chronic Refractory Cough market share of all therapies.

Chronic Refractory Cough Therapeutics Market Size by Countries

The total Chronic Refractory Cough treatment market size is analyzed for individual countries (the United States Market, EU4 (Germany, France, Italy, and Spain) and the UK market, and Japan). The United States accounted for a larger portion of the 7MM Chronic Refractory Cough Market in 2023 due to the high prevalence of the condition and treatment cost. This dominance is predicted to continue with the potential early entry of new products.  

Chronic Refractory Cough Drugs Market Size by Therapies

The current Chronic Refractory Cough Therapeutics Market is dominated by several non-effective treatment options such as neuro-modulating agents (opioids, baclofen, gabapentin, pregabalin, and amitriptyline), proton pump inhibitors, ICS, and others. Neuro-modulating agents occupy the major share in the current market. Current treatment is aimed at regulating and managing pain and neuropathic condition.

The total Chronic Refractory Cough Treatment Market Size based on currently prescribed therapies as well as emerging therapies, in the US, is expected to grow by 2034. DelveInsight assessment of the emerging therapies indicates that the Chronic Refractory Cough Drugs Market will experience a major shift in the market with the launch of several therapies during the forecast period (2024-2034).

Chronic Refractory Cough Drugs Uptake

This section focuses on the sales uptake of potential Chronic Refractory Cough drugs that have recently launched or are anticipated to be launched in the Chronic Refractory Cough market between 2020 and 2034. It estimates the market penetration of the Chronic Refractory Cough drugs for a given country, examining their impact within and across classes and segments. It also touches upon the financial and regulatory decisions contributing to the drug’s probability of success (PoS) in the Chronic Refractory Cough market. For example, for Gefapixant/MK-7264, we expect the drug uptake to be medium with a probability-adjusted peak share of around 5.2%, and years to the peak is expected to be 6 years from the year of launch in the US.

Chronic Refractory Cough Pipeline Development Activities

The Chronic Refractory Cough therapeutics market report provides insights into therapeutic candidates in Phase II and III stages. It also analyzes Chronic Refractory Cough Companies involved in developing targeted therapeutics.

Pipeline Development Activities

The Chronic Refractory Cough therapeutics market report covers information on collaborations, acquisition and merger, licensing, patent details, and other information for emerging Chronic Refractory Cough therapies.

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Latest KOL Views on Chronic Refractory Cough

To keep up with current Chronic Refractory Cough market trends and fill gaps in secondary findings, we interview KOLs and SMEs working in the Chronic Refractory Cough domain. Their opinion helps understand and validate current and emerging therapies and treatment patterns or Chronic Refractory Cough market trends. This will support the clients in potential upcoming novel treatments by identifying the overall scenario of the market and the Chronic Refractory Cough unmet needs.

Chronic Refractory Cough: KOL Insights

DelveInsight’s analysts connected with 50+ KOLs to gather insights; however, interviews were conducted with 15+ KOLs in the 7MM. These KOLs were from organizations, institutes, and hospitals, such as University of Cincinnati College of Medicine, US; Rutgers New Jersey Medical School, US; Ospedale Policlinico San Martino, Italy; Institute of General Practice and Family Medicine, Charité Universitätsmedizin Berlin, Germany; Department of Respiratory Diseases, University Hospital of Reims, France; Department of Respiratory Medicine and Tokyo Medical University Hachioji Medical Center, Hachioji, Japan; and others.

“No drug is approved for the Chronic Refractory Cough treatment in the US. There are drugs being evaluated for the patients. Orvepitant and other therapies are promising therapies for CRC that may modulate cough reflex hypersensitivity through a central-acting mechanism of action.”

Chronic Refractory Cough Therapeutics Market: Qualitative Analysis

We perform Qualitative and Chronic Refractory Cough Therapeutics Market Intelligence analysis using various approaches, such as SWOT analysis, and Conjoint Analysis. In the SWOT analysis, strengths, weaknesses, opportunities, and threats in terms of disease diagnosis, patient awareness, patient burden, competitive landscape, cost-effectiveness, and geographical accessibility of therapies are provided. These pointers are based on the Analyst’s discretion and assessment of the patient burden, cost analysis, and existing and evolving treatment landscape.

Conjoint Analysis is done to analyze multiple approved and emerging therapies based on relevant attributes such as safety, efficacy, frequency of administration, route of administration, and order of entry. Scoring is given based on these parameters to analyze the effectiveness of therapy.

Further, the therapies’ safety is evaluated wherein the acceptability, tolerability, and adverse events are majorly observed, and it sets a clear understanding of the side effects posed by the drug in the trials. In addition, the scoring is also based on the route of administration, order of entry and designation, probability of success, and the addressable patient pool for each therapy. According to these parameters, the final weightage score and the ranking of the emerging therapies are decided.

Chronic Refractory Cough Therapeutics Market Access and Reimbursement

Reimbursement is a crucial point for any drug after its approval. Many drugs or therapies are not properly recognized by the reimbursement body and may fail to get reimbursed or their reimbursement process gets delayed. DelveInsight’s ‘Chronic Refractory Cough Treatment Market Insights, Epidemiology, and Market Forecast – 2034’ report provides a descriptive overview of the market access and reimbursement scenario of Chronic Refractory Cough.

This section includes a detailed analysis of the country-wise healthcare system for each therapy, enlightening the market access, reimbursement policies, and health technology assessments. The report further provides detailed insights on the country-wise accessibility and reimbursement scenarios, cost-effectiveness scenario of approved therapies, programs making accessibility easier and out-of-pocket costs more affordable, insights on patients insured under federal or state government prescription drug programs, etc.

Note: Detailed assessment of Market Access and Reimbursement will be provided in the full report on Chronic Refractory Cough...

Chronic Refractory Cough Treatment Market Report Scope

• The Chronic Refractory Cough treatment market report covers a segment of key events, an executive summary, descriptive overview, explaining its causes, signs and symptoms, pathogenesis, and currently available therapies
• Comprehensive insight has been provided into the epidemiology segments and forecasts, the future growth potential of diagnosis rate, disease progression along with treatment guidelines
• Additionally, an all-inclusive account of both the current and emerging therapies along with the elaborative profiles of late-stage and prominent therapies will have an impact on the current Chronic Refractory Cough treatment market landscape
• A detailed review of the Chronic Refractory Cough drugs market; historical and forecasted Chronic Refractory Cough treatment market size, Chronic Refractory Cough market share by therapies, detailed assumptions, and rationale behind our approach is included in the report, covering the 7MM drug outreach
• The Chronic Refractory Cough treatment market report provides an edge while developing business strategies, by understanding trends, through SWOT analysis and expert insights/KOL views, patient journey, and treatment preference that help in shaping and driving the 7MM Chronic Refractory Cough drugs market

Chronic Refractory Cough Treatment Market Report Insights

• Patient-based Chronic Refractory Cough Market Forecasting
• Chronic Refractory Cough Therapeutic Approaches
• Chronic Refractory Cough Pipeline Analysis
• Chronic Refractory Cough Market Size and Trends
• Existing and future Chronic Refractory Cough Drugs Market Opportunity

Chronic Refractory Cough Market Report Key Strengths

• 11 Years Chronic Refractory Cough Market Forecast
• 7MM Coverage
• Chronic Refractory Cough Epidemiology Segmentation
• Key Cross Competition
• Attribute analysis
• Chronic Refractory Cough Drugs Uptake
• Key Chronic Refractory Cough Market Forecast Assumptions

Chronic Refractory Cough Market Report Assessment

• Current Chronic Refractory Cough Treatment Market Practices
• Chronic Refractory Cough Unmet Needs
• Chronic Refractory Cough Pipeline Product Profiles
• Chronic Refractory Cough Drugs Market Attractiveness
• Qualitative Analysis (SWOT and Conjoint Analysis)
• Chronic Refractory Cough Market Drivers
• Chronic Refractory Cough Market Barriers

Key Questions Answered in the Chronic Refractory Cough Market Report

Chronic Refractory Cough Market Insight

• What was the Chronic Refractory Cough Market Size, the Chronic Refractory Cough treatment market size by therapies, and market share (%) distribution in 2020, and how it would all look in 2034? What are the contributing factors for this growth?
• What are the unmet needs are associated with the current Chronic Refractory Cough treatment market?
• How is MK-7264 (gefapixant) going to contribute to the Chronic Refractory Cough Market after approval?
• Which drug is going to be the largest contributor in 2034?
• What are the pricing variations among different geographies for approved and off-label therapies?
• How would the market drivers, barriers, and future opportunities affect the market dynamics and subsequent analysis of the associated trends?

Chronic Refractory Cough Epidemiology Insights

• What are the disease risk, burden, and Chronic Refractory Cough unmet needs? What will be the growth opportunities across the 7MM concerning the patient population of Chronic Refractory Cough?
• What is the historical and forecasted Chronic Refractory Cough patient pool in the United States, EU4 (Germany, France, Italy, and Spain) the United Kingdom, and Japan?
• Why do only limited patients appear for diagnosis? Why is the current year diagnosis rate not high?
• What factors are affecting the diagnosis and treatment of the indication?

Current Chronic Refractory Cough Treatment Market Scenario, Marketed Drugs, and Emerging Therapies

• What are the current options for the Chronic Refractory Cough Treatment?
• What are the current treatment guidelines for the Chronic Refractory Cough treatment in the US and Europe?
• How many companies are developing therapies for the Chronic Refractory Cough treatment?
• How many emerging therapies are in the mid-stage and late stage of development for the Chronic Refractory Cough treatment?
• What are the recent novel therapies, targets, mechanisms of action, and technologies developed to overcome the limitation of existing therapies?
• What are the key designations that have been granted for the emerging therapies for Chronic Refractory Cough?
• Patient acceptability in terms of preferred treatment options as per real-world scenarios?
• What are the country-specific accessibility issues of expensive, recently approved therapies? Focus on reimbursement policies.
• What are the 7MM historical and forecasted Chronic Refractory Cough Drugs Market?

Reasons to Buy the Chronic Refractory Cough Market Report

• The Chronic Refractory Cough treatment market report will help in developing business strategies by understanding the latest trends and changing treatment dynamics driving the Chronic Refractory Cough Drugs Market
• Insights on patient burden/disease Chronic Refractory Cough Prevalence, evolution in diagnosis, and factors contributing to the change in the epidemiology of the disease during the forecast years
• To understand the existing Chronic Refractory Cough Drugs Market opportunity in varying geographies and the growth potential over the coming years.
• Distribution of historical and current patient share based on real-world prescription data along with reported sales of approved products in the US, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan.
• Identification of strong upcoming players in the Chronic Refractory Cough Drugs Market will help in devising strategies that will help in getting ahead of competitors.
• Detailed analysis and ranking of class-wise potential current and emerging therapies under the Conjoint analysis section to provide visibility around leading classes
• Highlights of Access and Reimbursement policies of approved therapies, barriers to accessibility of off-label expensive therapies, and patient assistance programs
• To understand the perspective of Key Opinion Leaders’ around the accessibility, acceptability, and compliance-related challenges of existing treatment to overcome barriers in future.
• Detailed insights on the unmet need of the existing Chronic Refractory Cough treatment market so that the upcoming players can strengthen their development and launch strategy

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