Chronic Refractory Cough Market

DelveInsight’s ‘Chronic Refractory Cough (CRC) - Market Insights, Epidemiology and Market Forecast– 2030’ report delivers an in-depth understanding of the Chronic Refractory Cough (CRC), historical and forecasted epidemiology as well as the Chronic Refractory Cough (CRC) market trends in the United States, EU5 (Germany, Spain, Italy, France, and United Kingdom) and Japan.

The Chronic Refractory Cough (CRC) market report provides current treatment practices, emerging drugs, and market share of the individual therapies, current and forecasted 7MM Chronic Refractory Cough (CRC) market size from 2018 to 2030. The report also covers current Chronic Refractory Cough (CRC) treatment practice/algorithm, market drivers, market barriers and unmet medical needs to curate the best of the opportunities and assesses the underlying potential of the market.

Geography Covered

  • The United States
  • EU5 (Germany, France, Italy, Spain, and the United Kingdom)
  • Japan

Study Period: 2018–2030

Chronic Refractory Cough (CRC) Disease Understanding and Treatment Algorithm

Chronic Refractory Cough (CRC) Overview

Chronic refractory cough (CRC) is defined as a cough lasting more than 8 weeks that persists despite guidelines based treatment which may be treated by different medical specialties: Pulmonology, Allergy and Immunology, Digestive Health and Otorhinolaryngology. Patients with chronic cough experience impaired quality of life and interruption of activities of daily living. It can result in depression and can persist for many months or years, despite systematic investigation and treatment of known causes. The infection can also be referred to as chronic cough, chronic idiopathic cough, unexplained chronic cough, and cough hypersensitivity syndrome. CRC is typically nonproductive and there is often a preceding history of viral respiratory tract infection. Patients frequently describe a dry, irritated cough which may be localized to the laryngeal region. Chronic coughs last more than 8 weeks and can be caused by gastroesophageal reflux disease (GERD), postnasal drip from sinus infections or allergies, or chronic lung conditions, such as asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, and interstitial lung diseases.


CRC is caused due to the recurrent occurrence of chronic cough. However, the signs and symptoms of chronic cough are similar to that of CRC. Persistent or chronic cough is one of the first and important symptoms and may signify respiratory involvement. Other pulmonary symptoms and signs include wheezing, stridor, dyspnea, hoarseness or aphonia, and tenderness over the laryngotracheal cartilage. Key symptoms include a dry irritating cough localized around the laryngeal region. Certain factors like smoking, allergies, chronic lung diseases, obesity and others can increase the risk of CRC.


CRC often occurs after a viral infection and multiple factors contribute to it, which is divided according to the conditions affecting the upper and lower respiratory tracts. Often the etiology can be multifactorial with more than one pathology present. Chronic cough causes social isolation, anxiety, and depression. Laryngopharyngeal reflux (LPR) is a common cause of CRC and may be present without symptoms of classic gastroesophageal reflux disease (GORD), including heartburn (silent reflux). There is an increasing awareness of neural hypersensitivity (laryngeal cough hypersensitivity syndrome) as a contributor to chronic cough and its pathophysiology has featured in common with neuropathic pain syndromes. Obstructive sleep apnoea syndrome (OSAS) has also recently been identified as an independent risk factor for chronic cough and a risk factor for LPR/GORD recalcitrant to medical therapy. ACE inhibitors are another common cause of CRC, which can occur spontaneously even after many years on this medication without previous problems. Sometimes, despite extensive investigation and trials of empirical therapy, the cause for cough remains unexplained and in such instances is termed an idiopathic or unexplained chronic cough. 


Chronic Refractory Cough (CRC) Diagnosis

CRC can be diagnosed when patients have no identified causes of chronic cough (unexplained or idiopathic chronic cough) or when the cough persists after investigation and treatment of cough related conditions (refractory chronic cough) because patients with unexplained chronic cough often receive specific therapies, such as inhaled corticosteroids or proton pump inhibitors, they can also be classified as having refractory chronic cough. The diagnosis of the disease is either done by primary or secondary assessment. The initial assessment for protracted or chronic cough is intended to characterize the condition based on history, to elicit any alarm symptoms or findings that may indicate a serious underlying disease, and to identify whether there is a specific disease present that is associated with chronic cough.


Chronic Refractory Cough (CRC) Treatment

The recognition that chronic cough is characterized by hypersensitivity of the peripheral and central neural pathways involved in cough has expanded the range of potential therapeutic targets currently under evaluation. Sensory nerves of the airways express a variety of receptors and ion channels that when activated trigger cough. It seems logical that these channels or receptors may represent therapeutic targets for cough. Manipulation of Transient receptor potential (TRP) channels on nociceptive neurons is proposed as an attractive strategy in the treatment of pain, and several drug developments targeting pain are focusing on these receptors. TRP channels are polymodal and directly activated by changes in temperature, chemicals, mechanical stimulation, pH and osmolality, which may evoke nociceptive responses, including cough. The TRP channel superfamily encompasses 28 members that can be divided into six subfamilies based on sequence homology. Of particular interest in relation to cough are members of the vanilloid (TRPV1, TRPV4), anykrin (TRPA1), and melastatin (TRPM8) families. Purinergic receptors include subtypes of P2X ion channel receptors which are activated by ATP and have received considerable attention recently as potential targets for the treatment of pain and cough. Voltage-gated sodium channels (NaV) mediate the initiation and propagation of action potentials in afferent sensory nerves and represent a potential therapeutic target for cough.


Chronic cough patients appear to have altered brain activity with evidence of both central sensitization and dysfunctional inhibitory control. Currently, the drugs used to treat or control cough that exerts their therapeutic effect centrally do so at the expense of undesirable effects, including sedation, respiratory depression, and addiction. Centrally acting neuromodulators—including gabapentin, pregabalin, morphine, amitriptyline, and baclofen—act on the heightened neural sensitization that is involved in the pathogenesis of CRC. All of these agents have improved cough specific quality of life in patients with CRC. However, although these treatments are promising, adverse effects can be serious and limit the maximum tolerable dose of these agents. Eosinophilic airway inflammation (eosinophilic bronchitis) is an important cause of chronic cough that can occur as a discrete condition or as part of asthma, cough variant asthma, rhinitis, or atopic cough. Inhaled corticosteroids are effective in eosinophilic airway inflammation. Additionally, proton pump inhibitors have also been used for the treatment of CRC.

Chronic Refractory Cough (CRC) Epidemiology

The disease epidemiology covered in the report provides historical as well as forecasted epidemiology segmented by Prevalent Population of Chronic Cough, Gender-specific Prevalent Population of Chronic Cough, Prevalent Population of Chronic Refractory Cough (CRC), Diagnosed Prevalent Population of Chronic Refractory Cough (CRC) and Diagnosed Prevalent Population of Chronic Refractory Cough (CRC) in Idiopathic Pulmonary Fibrosis (IPF) patients in the 7MM market covering the United States, EU5 countries (Germany, France, Italy, Spain, and United Kingdom) and Japan from 2018 to 2030.


Key Findings

This section provides glimpse of the Chronic Refractory Cough (CRC) epidemiology in the 7MM.

  • The total prevalent population of Chronic Cough in the 7 major markets was estimated to be 84,854,266 in 2020.
  • The prevalent population of CRC in the 7 major markets was estimated to be 17,600,264 in 2020.
  • The total diagnosed prevalent population of CRC in the 7 major markets was estimated to be 10,560,159 in 2020. In case of CRC patients in the United States, the diagnosed prevalent cases were 4,802,273 in 2020.
  • The diagnosed prevalent population of CRC in the 7 MM is expected to increase at a CAGR of 0.48% during the forecast period 2021–2030.
  • In the EU5 countries, the prevalent population of Chronic Cough was maximum in France with 8,799,771 cases, followed by the United Kingdom with 8,682,007 cases in 2020. While, Spain accounted for the lowest diagnosed prevalent population of the indication with 5,708,813 cases in 2020.
  • As per Delvelnsight’s analysis, Japan had 683,935 diagnosed prevalent cases of CRC in 2020.
  • In the United States, the total prevalent cases of Chronic Cough comprised of 10,805,114 males and 29,213,828 females in 2020.
  • The total number of diagnosed prevalent cases of CRC in IPF patients was 106,801 in the United States, in 2020.

Country Wise- Chronic Refractory Cough (CRC) Epidemiology

The epidemiology segment also provides the Chronic Refractory Cough (CRC) epidemiology data and findings across the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom) and Japan.

Chronic Refractory Cough (CRC) Drug Chapters

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


Chronic Refractory Cough (CRC) Emerging Drugs


Gefapixant: Merck

Gefaxipant is also known as AF-219 or MK-7264, which 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 chronic cough and CRC. It is believed that excessive activation of P2X3 receptors is associated with hyper-sensitization of sensory neurons. Neuronal hyper-sensitization in the airways and lungs, triggered by injury or infection, can cause an exaggerated, persistent and frequent urge to cough, so called chronic cough. The primary vagal fibers mediating cough consist of Aδ-fibres (with cell bodies in the inferior vagal ganglion that are highly sensitive to mechanical stimulation) and C-fibers (with cell bodies in the superior vagal ganglion that are responsive to chemical stimuli and are recruited in response to inflammation or the presence of chemical irritants). Adenosine triphosphate (ATP)-gated P2X3-containing receptors play a significant role in the activation of these sensory fibers central to cough initiation. Thus, ATP induces action potentials in no dose C-fibers, and this activation is inhibited by blockade of P2X3 and P2X2/3 receptors.

Product details in the report…


Orvepitant Maleate: Nerre Therapeutics

Orvepitant (GW823296) is a novel generation brain penetrant, selective and potent, small molecule NK-1 receptor antagonist. Orvepitant’s mode of action and characteristics made it a suitable candidate for the treatment of common anxiety disorders, post-traumatic stress disorder, and major depressive disorder. It acts to reduce the central neural hypersensitivity that underlies chronic cough. Orvepitant has been administered to approximately 900 individuals to date and has demonstrated a clear benefit and reduces the symptoms of RUCC in the open label Phase IIa study “VOLCANO-1” and this benefit was confirmed more recently in the dose range finding Phase IIb study “VOLCANO-2”. The drug has already completed phase II clinical trial for CRC and is now being advanced by NeRRe into a Phase III program for this indication.

Product details in the report…


BLU-5937: Bellus Health

Bellus Health’s lead drug candidate, BLU-5937 (formerly known as NEO5937), is a potent, highly selective, orally bioavailable small molecule antagonist of the P2X3 receptor, a clinically validated target for chronic cough. BLU-5937 has the potential to be a best-in-class therapeutic for CRC patients. BLU-5937 has been shown to be highly selective (>1500-fold) for human P2X3 receptors versus P2X2/3 receptors. Currently, the drug is in phase IIb (SOOTHE) stage of clinical development in patients with CRC. An interim analysis is expected to be conducted once 50% of patients have completed the main study and is anticipated in mid-2021.

Product details in the report…


S-600918: Shionogi

S-600918 is an oral, P2X3 receptor antagonist, antitussive agent that is being developed by Shionogi for refractory/unexpected chronic cough. It has high selectivity for P2X3 homomer compared with P2X2/3 heteromer, which could reduce coughs with minimal taste-related side effects. The company has already completed a phase IIb proof of concept (POC) study in Japan for CRC and the results were presented at the European Respiratory Society International Congress (ERS 2019). Currently, the company is conducting a global phase II developmental trial of the drug for CRC. Additionally, the company expects to launch this drug for CRC between 2025 and 2028.

Product details in the report…


BAY1817080 (Eliapixant): Bayer

BAY1817080 (Eliapixant), a purinoreceptor antagonist is a natural mediators of pain as well as an inducer of neurogenic inflammation and are known to play a role in the cough reflex. It is a small molecule that attaches to P2X3 receptor– to interfere with the channels which pass on the signals aim to eliminate the chance of exaggerated signals responsible for refractory/unexplained chronic cough (RUCC) as a long-term treatment option offering a huge relief for the patients.

Product details in the report…

Chronic Refractory Cough (CRC) Market Outlook

Chronic refractory cough proves to be a huge burden on the patients who are fighting this debilitating condition. CRC is typically nonproductive and there is often a preceding history of viral respiratory tract infection. Patients frequently describe a dry, irritating cough which may be localized to the laryngeal region. It significantly impairs patients' quality of life. Unfortunately, in many situations, patients continue to experience CRC in spite of following published guidelines for diagnosis and treatment.


Currently, the market holds no approved therapy to treat chronic refractory cough. According to the recent guidelines published by American College of Chest Physicians (ACCP) four categories of treatment can be implemented which include nonpharmacologic therapies, inhaled corticosteroids, neuromodulatory therapies, and other therapies.


The market of CRC is mainly dominated by nonpharmacologic therapies, which include Speech Therapy and Physiotherapy. After nonpharmacological therapies, the market holds various types of pharmacologic therapies which include Neuromodulators, Proton pump inhibitors, Inhaled Corticosteroids, 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. One of the most commonly used drugs is codeine, which is generally regarded as a weak opioid and found naturally in extracts of the poppy. Similarly, morphine, tramadol, etc. can also be used to get relief in chronic cough. Gabapentin is also considered as an option to treat CRC that binds to the α2δ subunit of the voltage-dependent calcium channel, thereby regulating neurotransmitter release. Amitriptyline is an inhibitor of serotonin reuptake but may also have effects on the muscarinic, adrenergic, and histaminergic systems. Treatment of chronic cough with amitriptyline is reported to reduce cough in several studies. Another drug that can be used for treating a chronic refractory cough is Baclofen which, is a Gamma-Aminobutyric Acid (GABA) agonist which provides relief from the pain associated with cough. Other class of drugs that are used to treat CRC include Inhaled corticosteroids, which are effective in eosinophilic airway inflammation.


Combined therapy can also be employed to treat the patients of CRC. This includes the use of nonpharmacologic and pharmacologic interventions together, i.e., combining speech therapy with drugs to provide relief to the patients. There are several other treatment options also followed for the CRC patients. A drug like esomeprazole, which is a proton pump inhibitor helps in relieving the acid-reflux in cough associated with GOR. Another drug Ipratropium bromide is used as a bronchodilator, which can provide short-term relief from cough.


Chronic Refractory Disorder pipeline possesses potential drugs in late and mid-stage developments to be launched in the near future. Gefapixant (Merck) is currently in the Phase III stage of development followed by Orvepitant Maleate (Nerre Therapeutics), BLU-5937 (Bellus Health), Bradanicline (Attenua), S-600918 (Shionogi), and BAY1817080 (Bayer) in phase II stages of development.


Key Findings

This section includes a glimpse of the Chronic Refractory Cough (CRC) 7MM market.

  • The market size of CRC in the seven major markets was estimated to be USD 6,118.6 Million in 2020, which is expected to show a positive growth at a CAGR of 6.57% during the study period 2018–2030.
  • The United States accounts for the largest market size of CRC throughout the study period of 2018–2030, in comparison to EU5 (the United Kingdom, Germany, Italy, France, and Spain) and Japan, which was estimated to be USD 3,326.6 Million in 2020.
  • Among the EU5 countries, France had the highest market size with USD 623.4 Million in 2020, while Spain had the lowest market size with USD 332.2 Million in 2020.
  • The Japan CRC market accounted for USD 331.6 Million in 2020.


The United States Market Outlook

This section provides the total Chronic Refractory Cough (CRC) market size and market size by therapies in the United States.


EU-5 Market Outlook

The total CRC market size and market size by therapies in Germany, France, Italy, Spain, and the United Kingdom are provided in this section.


Japan Market Outlook

The total Chronic Refractory Cough (CRC) market size and market size by therapies in Japan are provided.

Chronic Refractory Cough (CRC) Drugs Uptake

This section focusses on the rate of uptake of the potential drugs recently launched in the Chronic Refractory Cough (CRC) market or expected to get launched in the market during the study period 2018–2030. The analysis covers Chronic Refractory Cough (CRC) market uptake by drugs; patient uptake by therapies; and sales of each drug.  


This helps in understanding the drugs with the most rapid uptake, reasons behind the maximal use of new drugs and allow the comparison of the drugs on the basis of market share and size which again will be useful in investigating factors important in market uptake and in making financial and regulatory decisions.

Chronic Refractory Cough (CRC) Development Activities

The report provides insights into different therapeutic candidates in phase II, and phase III stage. It also analyzes key players involved in developing targeted therapeutics.


Pipeline Development Activities

The report covers the detailed information of collaborations, acquisition and merger, licensing and patent details for Chronic Refractory Cough (CRC) emerging therapies.

Competitive Intelligence Analysis

We perform competitive and market Intelligence analysis of the Chronic Refractory Cough (CRC) market by using various competitive intelligence tools that include–SWOT analysis, PESTLE analysis, Porter’s five forces, BCG Matrix, Market entry strategies, etc. The inclusion of the analysis entirely depends upon the data availability.

Scope of the Report

  • The report covers the descriptive overview of Chronic Refractory Cough (CRC), explaining its causes, signs and symptoms, pathogenesis and currently available therapies.
  • Comprehensive insight has been provided into the Chronic Refractory Cough (CRC) epidemiology and treatment.
  • Additionally, an all-inclusive account of both the current and emerging therapies for Chronic Refractory Cough (CRC) are provided, along with the assessment of new therapies, which will have an impact on the current treatment landscape.
  • A detailed review of Chronic Refractory Cough (CRC) market; historical and forecasted is included in the report, covering the 7MM drug outreach.
  • The report provides an edge while developing business strategies, by understanding trends shaping and driving the 7MM Chronic Refractory Cough (CRC) market.

Report Highlights

  • In the coming years, Chronic Refractory Cough (CRC) market is set to change due to the rising awareness of the disease, and incremental healthcare spending across the world; which would expand the size of the market to enable the drug manufacturers to penetrate more into the market.
  • The companies and academics are working to assess challenges and seek opportunities that could influence Chronic Refractory Cough (CRC) R&D. The therapies under development are focused on novel approaches to treat/improve the disease condition.
  • Delvelnsight has analysed prevalent population of Chronic cough and CRC in the 7MM for the study period of 2018–2030.
  • Diagnosed prevalence of CRC was also assessed, which suggests that the cases of CRC will increase during the forecast period of 2021–2030.
  • In addition, gener-specific prevalence of Chronic Cough was assessed as well. As per the analysis, CRC is more prevalent in females than in males.
  • The scope of the report also encompasses another major segment, i.e., Diagnosed Prevalent Population of CRC in IPF patients, wherein the number of IPF patients suffering from CRC was calculated.
  • Currently, the treatment regimen of CRC involves the use of Neuro-modulating agents (Opioids, Baclofen, Gabapentin, Pregablin, and Amitriptyline), Proton Pump inhibitors, Inhaled corticosteroids (ICs) and others.
  • Expected Launch of potential therapies, Orvepitant Maleate, BLU-5937, Gefapixant (MK-7264), BAY1817080 (Eliapixant) and S-600918, may increase market size in the coming years, assisted by an increase in CRC prevalent population pool. Owing to the positive outcomes of the upcoming products by key players such as Nerre Therapeutics, Bellus Health, Merck, , Bayer and Shionogi the CRC market will create a significant positive shift in the market size.

Analyst Comments

  • Among all the potential emerging therapies, Gefapixant (MK-7264), which is being developed by Merck is estimated to enter the CRC market at the earliest, as the drug has already completed several phase II and III developmental trials successfully. The drug has demonstrated quiet impressive efficacy and a consistent safety and tolerability profile. Besides, a major drawback that comes with this therapy is the incidence of serious adverse events and high incidence of taste-related adverse events, which led to few treatment discontinuations. However, due to high unmet needs and lack of approved therapies, the probability of success of Gefapixant is expected to be quite high.
  • Another major potential emerging therapy is Orvepitant Maleate (Nerre Therapeutics). This therapy has demonstrated no safety concerns in the treated population with excellent tolerability. Additionally, the reduction in cough frequency in patients was observed to be near significant. Therefore, if approved, this therapy may capture an impressive market share in the forecast period with high compliance rate in comparison to other emerging therapies.
  • Furthermore, it is important to note that all the emerging therapies except for Orvepitant Maleate works as an antagonist to P2X3 receptor, however, Nerre Therapeutics’ candidate targets Neurokinin-1 receptor (NK-1RA). As result, all the emerging therapies except for Orvepitant Maleate are expected to face major competition upon approval.

Chronic Refractory Cough (CRC) Report Insights

  • Patient Population
  • Therapeutic Approaches
  • Chronic Refractory Cough (CRC) Pipeline Analysis
  • Chronic Refractory Cough (CRC) Market Size and Trends
  • Market Opportunities
  • Impact of upcoming Therapies

Chronic Refractory Cough (CRC) Report Key Strengths

  • Ten Years Forecast
  • 7MM Coverage
  • Chronic Refractory Cough (CRC) Epidemiology Segmentation
  • Key Cross Competition
  • Highly Analyzed Market
  • Drugs Uptake

Chronic Refractory Cough (CRC) Report Assessment

  • Current Treatment Practices
  • Unmet Needs
  • Pipeline Product Profiles
  • Market Attractiveness
  • Market Drivers and Barriers

Key Questions

Market Insights:

  • What was the Chronic Refractory Cough (CRC) market share (%) distribution in 2018 and how it would look like in 2030?
  • What would be the Chronic Refractory Cough (CRC) total market size as well as market size by therapies across the 7MM during the forecast period (2021–2030)?
  • What are the key findings pertaining to the market across the 7MM and which country will have the largest Chronic Refractory Cough (CRC) market size during the forecast period (2021–2030)?
  • At what CAGR, the Chronic Refractory Cough (CRC) market is expected to grow at the 7MM level during the forecast period (2021–2030)?
  • What would be the Chronic Refractory Cough (CRC) market outlook across the 7MM during the forecast period (2021–2030)?
  • What would be the Chronic Refractory Cough (CRC) market growth till 2030 and what will be the resultant market size in the year 2030?
  • How would the market drivers, barriers and future opportunities affect the market dynamics and subsequent analysis of the associated trends?


Epidemiology Insights:

  • What is the disease risk, burden and unmet needs of Chronic Refractory Cough (CRC)?
  • What is the historical Chronic Refractory Cough (CRC) patient pool in the United States, EU5 (Germany, France, Italy, Spain, and the UK) and Japan?
  • What would be the forecasted patient pool of Chronic Refractory Cough (CRC) at the 7MM level?
  • What will be the growth opportunities across the 7MM with respect to the patient population pertaining to Chronic Refractory Cough (CRC)?
  • Out of the above-mentioned countries, which country would have the highest prevalent population of Chronic Refractory Cough (CRC) during the forecast period (2021–2030)?
  • At what CAGR the population is expected to grow across the 7MM during the forecast period (2021–2030)?


Current Treatment Scenario, Marketed Drugs and Emerging Therapies:

  • What are the current options for the treatment of Chronic Refractory Cough (CRC) along with the approved therapy?
  • What are the current treatment guidelines for the treatment of Chronic Refractory Cough (CRC) in the US and Europe?
  • What are the Chronic Refractory Cough (CRC) marketed drugs and their MOA, regulatory milestones, product development activities, advantages, disadvantages, safety and efficacy, etc.?
  • How many companies are developing therapies for the treatment of Chronic Refractory Cough (CRC)?
  • How many therapies are developed by each company for the treatment of Chronic Refractory Cough (CRC)?
  • How many emerging therapies are in the mid-stage and late stage of development for the treatment of Chronic Refractory Cough (CRC)?
  • What are the key collaborations (Industry–Industry, Industry–Academia), Mergers and acquisitions, licensing activities related to the Chronic Refractory Cough (CRC) therapies?
  • What are the recent novel therapies, targets, mechanisms of action and technologies developed to overcome the limitation of existing therapies?
  • What are the clinical studies going on for Chronic Refractory Cough (CRC) and their status?
  • What are the key designations that have been granted for the emerging therapies for Chronic Refractory Cough (CRC)?
  • What are the 7MM historical and forecasted market of Chronic Refractory Cough (CRC)?

Reasons to buy

  • The report will help in developing business strategies by understanding trends shaping and driving the Chronic Refractory Cough (CRC).
  • To understand the future market competition in the CRC market and Insightful review of the key market drivers and barriers.
  • Organize sales and marketing efforts by identifying the best opportunities for Chronic Refractory Cough (CRC) in the US, Europe (Germany, Spain, Italy, France, and the United Kingdom) and Japan.
  • Identification of strong upcoming players in the market will help in devising strategies that will help in getting ahead of competitors.
  • Organize sales and marketing efforts by identifying the best opportunities for Chronic Refractory Cough (CRC) market.
  • To understand the future market competition in the Chronic Refractory Cough (CRC) market.

1. Key Insights

2. Executive Summary

3. Chronic Refractory Cough Market Overview at a Glance

3.1. Market Share (%) Distribution of Chronic Refractory Cough in 2018

3.2. Market Share (%) Distribution of Chronic Refractory Cough in 2030

4. Disease Background and Overview: Chronic Refractory Cough (CRC)

4.1. Introduction

4.2. Signs and Symptoms

4.3. Causes

4.4. Risk Factors

4.5. Mechanism of Chronic Cough

4.6. Pathophysiology of Chronic Cough

4.7. Similarity Between Chronic Refractory Cough and Other Neuropathic Disorder

4.7.1. Cough hypersensitivity syndrome and Chronic Refractory Cough

4.7.2. Laryngeal hypersensitivity

4.8. Pathogenesis of Chronic Refractory Cough

4.8.1. Cough reflex hypersensitivity

4.8.2. Peripheral sensitization

4.8.3. Central sensitization

4.8.4. Paradoxical vocal fold movement

4.9. Clinical Features of CRC

4.10. Diagnosis

4.10.1. Primary assessment

4.10.2. Secondary assessment

5. Epidemiology and Patient Population

5.1. Key Findings

5.2. 7MM Prevalent Population of Chronic Cough

5.3. 7MM Prevalent Population of Chronic Refractory Cough (CRC)

5.4. 7MM Diagnosed Prevalent Population of Chronic Refractory Cough (CRC)

6. Country-Wise Epidemiology of Chronic Refractory Cough

6.1. United States

6.1.1. Assumptions and Rationale

6.1.2. Prevalent Population of Chronic Cough in the United States

6.1.3. Gender-specific Prevalent Population of Chronic Cough in the United States

6.1.4. Prevalent Population of Chronic Refractory Cough in the United States

6.1.5. Diagnosed Prevalent Population of Chronic Refractory Cough in the United States

6.1.6. Diagnosed Prevalent Population of Chronic Refractory Cough in Idiopathic Pulmonary Fibrosis (IPF) patients in the United States

6.2. EU5 Countries

6.2.1. Assumptions and Rationale

6.3. Germany

6.3.1. Prevalent Population of Chronic Cough in Germany

6.3.2. Gender-specific Prevalent Population of Chronic Cough in Germany

6.3.3. Prevalent Population of Chronic Refractory Cough in Germany

6.3.4. Diagnosed Prevalent Population of Chronic Refractory Cough in Germany

6.3.5. Diagnosed Prevalent Population of Chronic Refractory Cough in Idiopathic Pulmonary Fibrosis (IPF) patients in Germany

6.4. France

6.4.1. Prevalent Population of Chronic Cough in France

6.4.2. Gender-specific Prevalent Population of Chronic Cough in France

6.4.3. Prevalent Population of Chronic Refractory Cough in France

6.4.4. Diagnosed Prevalent Population of Chronic Refractory Cough in France

6.4.5. Diagnosed Prevalent Population of Chronic Refractory Cough in Idiopathic Pulmonary Fibrosis (IPF) patients in France

6.5. Italy

6.5.1. Prevalent Population of Chronic Cough in Italy

6.5.2. Gender-specific Prevalent Population of Chronic Cough in Italy

6.5.3. Prevalent Population of Chronic Refractory Cough in Italy

6.5.4. Diagnosed Prevalent Population of Chronic Refractory Cough in Italy

6.5.5. Diagnosed Prevalent Population of Chronic Refractory Cough in Idiopathic Pulmonary Fibrosis (IPF) patients in Italy

6.6. Spain

6.6.1. Prevalent Population of Chronic Cough in Spain

6.6.2. Gender-specific Prevalent Population of Chronic Cough in Spain

6.6.3. Prevalent Population of Chronic Refractory Cough in Spain

6.6.4. Diagnosed Prevalent Population of Chronic Refractory Cough in Spain

6.6.5. Diagnosed Prevalent Population of Chronic Refractory Cough in Idiopathic Pulmonary Fibrosis (IPF) patients in Spain

6.7. United Kingdom

6.7.1. Prevalent Population of Chronic Cough in the United Kingdom

6.7.2. Gender-specific Prevalent Population of Chronic Cough in the United Kingdom

6.7.3 Prevalent Population of Chronic Refractory Cough in the United Kingdom

6.7.4. Diagnosed Prevalent Population of Chronic Refractory Cough in the United Kingdom

6.7.5. Diagnosed Prevalent Population of Chronic Refractory Cough in Idiopathic Pulmonary Fibrosis (IPF) patients in the United Kingdom

6.8. Japan

6.8.1. Assumptions and Rationale

6.8.1. Prevalent Population of Chronic Cough in Japan

6.8.2. Gender-specific Prevalent Population of Chronic Cough in Japan

6.8.3. Prevalent Population of Chronic Refractory Cough in Japan

6.8.4. Diagnosed Prevalent Population of Chronic Refractory Cough in Japan

6.8.5. Diagnosed Prevalent Population of Chronic Refractory Cough in Idiopathic Pulmonary Fibrosis (IPF) patients in Japan

7. Recognized Establishment

8. Treatment

8.1. Treatments with a Peripheral Site of Action

8.1.1. TRP Channels

8.1.2. Purinergic Receptors

8.1.3. Voltage-Gated Sodium Channels

8.2. Treatments with a Central Site of Action

8.2.1. Opiates (Morphine Sulphate/Codeine/Tramadol)

8.2.2. GABA-Related Compounds (Gabapentin, Pregabalin)

8.2.3. N-Methyl-D-Aspartate (NMDA) Receptors

8.2.4. Amitriptyline

8.2.5. Tachykinin Receptor Antagonists

8.2.6. Nicotinic Acetylcholine Receptors

8.3. Management of Chronic Cough

9. European Guidelines on Chronic Cough

9.1. EUROPEAN RESPIRATORY SOCIETY (ERS) GUIDELINES ON THE DIAGNOSIS AND TREATMENT OF CHRONIC COUGH IN ADULTS AND CHILDREN (2020)

10. United States GUIDELINE Guidelines on Chronic Refractory Cough

10.1. TREATMENT OF UNEXPLAINED CHRONIC COUGH CHEST GUIDELINE AND EXPERT PANEL REPORT

10.2. SUMMARY OF RECOMMENDATIONS AND SUGGESTIONS

11. Unmet Needs

12. Emerging Drugs

12.1. Key Competitor

12.2. Gefapixant: Merck

12.2.1. Product Description

12.2.2. Other Developmental Activities

12.2.3. Clinical Development

12.2.4. Safety and Efficacy

12.2.5. Product Profile

12.3. Orvepitant Maleate: Nerre Therapeutics

12.3.1. Product Description

12.3.2. Other Developmental Activities

12.3.3. Clinical Development

12.3.4. Safety and Efficacy

12.3.5. Product Profile

12.4. BLU-5937:Bellus Health

12.4.1. Product Description

12.4.2. Other Developmental Activities

12.4.3. Clinical Development

12.4.4. Safety and Efficacy

12.4.5. Product Profile

12.5. S-600918: Shionogi

12.5.1. Product Description

12.5.2. Clinical Development

12.5.3. Safety and Efficacy

12.5.4. Product Profile

12.6. BAY1817080 (Eliapixant): Bayer

12.6.1. Drug Description

12.6.2. Other Development Activities

12.6.3. Clinical Development

12.6.4. Safety and Efficacy

12.6.5. Product Profile

13. Market Access and Reimbursement

13.1. United States

13.2. EU5 and Japan

14. Chronic Refractory Cough: Seven Major Market Analysis

14.1. Key Findings

14.2. Market Size of Chronic Refractory Cough in the 7MM

14.3. 7MM Market Outlook

14.4. United States Market Size

14.4.1. Total Market size of Chronic Refractory Cough

14.4.2. Market Size by Current Therapies

14.4.3. Market Size by Emerging Therapies

15. EU-5 Countries Market Size

15.1. Germany

15.1.1. Total Market size of Chronic Refractory Cough in Germany

15.1.2. Market Size by Current Therapies

15.1.3. Market size by Emerging Therapies

15.2. France

15.2.1. Total Market Size of Chronic Refractory Cough

15.2.2. Market Size by Current Therapies

15.2.3. Market Size by Emerging Therapies

15.3. Italy

15.3.1. Total Market Size of Chronic Refractory Cough

15.3.2. Market Size by Current Therapies

15.3.3. Market Size by Emerging Therapies

15.4. Spain

15.4.1. Total Market Size of Chronic Refractory Cough

15.4.2. Market Size by Current Therapies

15.4.3. Market Size by Emerging Therapies

15.5. United Kingdom

15.5.1. Total Market Size of Chronic Refractory Cough

15.5.2. Market Size by Current Therapies

15.5.3. Market Size by Emerging Therapies

16. Japan Market Size

16.1. Total Market Size of Chronic Refractory Cough

16.2. Market Size by Current Therapies

16.3. Market Size by Emerging Therapies

17. Case Report

18. Market Drivers

19. Market Barriers

20. SWOT Analysis

21. KOL Views

22. Appendix

22.1. Bibliography

23. Report Methodology

24. DelveInsight Capabilities

25. Disclaimer

26. About DelveInsight

List of Table

Table 1: Summary of CRC, Market, Epidemiology and Key Events (2018–2030)

Table 2: Total Prevalent Population of Chronic cough in the 7MM (2018–2030)

Table 3: Total Prevalent Population of Chronic Refractory Cough in the 7MM (2018–2030)

Table 4: Total Diagnosed Prevalent Population of CRC in the 7MM (2018–2030)

Table 5: Prevalent Population of Chronic Cough in the United States (2018–2030)

Table 6: Gender-specific Prevalent Population of Chronic Cough in the United States (2018–2030)

Table 7: Prevalent Population of CRC in the United States (2018–2030)

Table 8: Diagnosed Prevalent Population of CRC in the United States (2018–2030)

Table 9: Diagnosed Prevalent Population of CRC in IPF patients in the United States (2018–2030)

Table 10: Prevalent Population of Chronic Cough in Germany (2018–2030)

Table 11: Gender-specific Prevalent Population of Chronic Cough in Germany (2018–2030)

Table 12: Prevalent Population of CRC in Germany (2018–2030)

Table 13: Diagnosed Prevalent Population of CRC in Germany (2018–2030)

Table 14: Diagnosed Prevalent Population of CRC in IPF patients in Germany (2018–2030)

Table 15: Prevalent Population of Chronic Cough in France (2018–2030)

Table 16: Gender-specific Prevalent Population of Chronic Cough in France (2018–2030)

Table 17: Prevalent Population of CRC in France (2018–2030)

Table 18: Diagnosed Prevalent Population of CRC in France (2018–2030)

Table 19: Diagnosed Prevalent Population of CRC in IPF patients in France (2018–2030)

Table 20: Prevalent Population of Chronic Cough in Italy (2018–2030)

Table 21: Gender-specific Prevalent Population of Chronic Cough in Italy (2018–2030)

Table 22: Prevalent Population of CRC in Italy (2018–2030)

Table 23: Diagnosed Prevalent Population of CRC in Italy (2018–2030)

Table 24: Diagnosed Prevalent Population of CRC in IPF patients in Italy (2018–2030)

Table 25: Prevalent Population of Chronic Cough in Spain (2018–2030)

Table 26: Gender-specific Prevalent Population of Chronic Cough in Spain (2018–2030)

Table 27: Prevalent Population of CRC in Spain (2018–2030)

Table 28: Diagnosed Prevalent Population of CRC in Spain (2018–2030)

Table 29: Diagnosed Prevalent Population of CRC in IPF patients in Spain (2018–2030)

Table 30: Prevalent Population of Chronic Cough in the United Kingdom (2018–2030)

Table 31: Gender-specific Prevalent Population of Chronic Cough in the United Kingdom (2018–2030)

Table 32: Prevalent Population of CRC in the United Kingdom (2018–2030)

Table 33: Diagnosed Prevalent Population of CRC in the United Kingdom (2018–2030)

Table 34: Diagnosed Prevalent Population of CRC in IPF patients in the United Kingdom (2018–2030)

Table 35: Prevalent Population of Chronic Cough in Japan (2018–2030)

Table 36: Gender-specific Prevalent Population of Chronic Cough in Japan (2018–2030)

Table 37: Prevalent Population of CRC in Japan (2018–2030)

Table 38: Diagnosed Prevalent Population of CRC in Japan (2018–2030)

Table 39: Diagnosed Prevalent Population of CRC in IPF patients in Japan (2018–2030)

Table 40: Recommendations, strength and level of evidence, and supporting remarks for the diagnosis and treatment of chronic cough in adults and children

Table 41: Comparison of cough guidelines in relation to chronic refractory cough (CRC)

Table 42: Comparison of emerging drugs under development

Table 43: Gefapixant, Clinical Trial Description, 2021

Table 44: Orvepitant Maleate, Clinical Trial Description, 2021

Table 45: BLU-5937, Clinical Trial Description, 2021

Table 46: S-600918, Clinical Trial Description, 2021

Table 47: BAY1817080, Clinical Trial Description, 2021

Table 48: Seven Major Market Size of CRC in USD Million (2018–2030)

Table 49: Launch dates

Table 50: United States Market Size of CRC , USD Million (2018–2030)

Table 51: Market size of CRC by Current therapies in United States, in USD Million (2018–2030)

Table 52: Market size of CRC by emerging therapies in United States, in USD Million (2018–2030)

Table 53: Market Size of CRC in Germany, in USD Million (2018–2030)

Table 54: Market size of CRC by Current therapies in Germany, in USD Million (2018–2030)

Table 55: Market size of CRC by emerging therapies in Germany, in USD Million (2018–2030)

Table 56: Market Size of CRC in France, in USD Million (2018–2030)

Table 57: Market size of CRC by Current therapies in France, in USD Million (2018–2030)

Table 58: Market size of CRC by Emerging therapies in France, in USD Million (2018–2030)

Table 59: Market Size of CRC in Italy, in USD Million (2018–2030)

Table 60: Market size of CRC by Current Therapies in Italy, in USD Million (2018–2030)

Table 61: Market size of CRC by Emerging therapies in Italy, in USD Million (2018–2030)

Table 62: Market Size of CRC in Spain, in USD Million (2018–2030)

Table 63: Market size of CRC by Current therapies in Spain, in USD Million (2018–2030)

Table 64: Market size of CRC by Emerging therapies in Spain, in USD Million (2018–2030)

Table 65: Market Size of CRC in the UK, in USD Million (2018–2030)

Table 66: Market size of CRC by Current therapies in the UK, in USD Million (2018–2030)

Table 67: Market size of CRC by Emerging therapies in the UK, in USD Million (2018–2030)

Table 68: Market Size of CRC in Japan, in USD Million (2018–2030)

Table 69: Market size of CRC by Current therapies in Japan, in USD Million (2018–2030)

Table 70: Market size of CRC by Emerging therapies in Japan, in USD Million (2018–2030)

List of Figures

Figure 1: Symptoms of Chronic Refractory Cough

Figure 2: Origins and neurological pathways of the cough reflex.

Figure 3: Total Prevalent Population of Chronic cough in the 7MM (2018–2030)

Figure 4: Diagnosed Prevalent Population of Chronic Refractory Cough in the 7MM (2018–2030)

Figure 5: Diagnosed Prevalent Population of CRC in the 7MM (2018–2030)

Figure 6: Prevalent Population of Chronic Cough in the United States (2018–2030)

Figure 7: Gender-specific Prevalent Population of Chronic Cough in the United States (2018–2030)

Figure 8: Prevalent Population of CRC in the United States (2018–2030)

Figure 9: Diagnosed Prevalent Population of CRC in the United States (2018–2030)

Figure 10: Diagnosed Prevalent Population of CRC in IPF patients in the United States (2018–2030)

Figure 11: Prevalent Population of Chronic Cough in Germany (2018–2030)

Figure 12: Gender-specific Prevalent Population of Chronic Cough in Germany (2018–2030)

Figure 13: Prevalent Population of CRC in Germany (2018–2030)

Figure 14: Diagnosed Prevalent Population of CRC in Children in Germany (2018–2030)

Figure 15: Diagnosed Prevalent Population of CRC in IPF patients in Germany (2018–2030)

Figure 16: Prevalent Population of CRC in France (2018–2030)

Figure 17: Gender-specific Prevalent Population of Chronic Cough in France (2018–2030)

Figure 18: Prevalent Population of CRC in France (2018–2030)

Figure 19: Diagnosed Prevalent Population of CRC in France (2018–2030)

Figure 20: Diagnosed Prevalent Population of CRC in IPF patients in France (2018–2030)

Figure 21: Prevalent Population of Chronic Cough in Italy (2018–2030)

Figure 22: Gender-specific Prevalent Population of Chronic Cough in Italy (2018–2030)

Figure 23: Prevalent Population of CRC in Italy (2018–2030)

Figure 24: Diagnosed Prevalent Population of CRC in Italy (2018–2030)

Figure 25: Diagnosed Prevalent Population of CRC in IPF patients in Italy (2018–2030)

Figure 26: Prevalent Population of Chronic Cough in Spain (2018–2030)

Figure 27: Gender-specific Prevalent Population of Chronic Cough in Spain (2018–2030)

Figure 28: Prevalent Population of CRC in Spain (2018–2030)

Figure 29: Diagnosed Prevalent Population of CRC in Spain (2018–2030)

Figure 30: Diagnosed Prevalent Population of CRC in IPF patients in Spain (2018–2030)

Figure 31: Prevalent Population of Chronic Cough in the United Kingdom (2018–2030)

Figure 32: Gender-specific Prevalent Population of Chronic Cough in the United Kingdom (2018–2030)

Figure 33: Prevalent Population of CRC in the United Kingdom (2018–2030)

Figure 34: Diagnosed Prevalent Population of CRC in the United Kingdom (2018–2030)

Figure 35: Diagnosed Prevalent Population of CRC in IPF patients in the United Kingdom (2018–2030)

Figure 36: Prevalent Population of Chronic Cough in Japan (2018–2030)

Figure 37: Gender-specific Prevalent Population of Chronic Cough in Japan (2018–2030)

Figure 38: Prevalent Population of CRC in Japan (2018–2030)

Figure 39: Diagnosed Prevalent Population of CRC in Japan (2018–2030)

Figure 40: Diagnosed Prevalent Population of CRC in IPF patients in Japan (2018–2030)

Figure 41: A proposed algorithm detailing a management approach to the patient with “difficult-to-treat” cough

Figure 42: Unmet Needs of Chronic Refractory Cough

Figure 43: Seven Major Market Size of CRC in USD Million (2018–2030)

Figure 44: Market Size of CRC in the United States, USD Millions (2018–2030)

Figure 45: Market size of CRC by Current therapies in the US, in USD Million (2018–2030)

Figure 46: Market size of CRC by emerging therapies in the US, in USD Million (2018–2030)

Figure 47: Market Size of CRC in Germany, USD Million (2018–2030)

Figure 48: Market Size of CRC by Current therapies, in Germany, in USD Million (2018–2030)

Figure 49: Market Size of CRC by emerging therapies, in Germany, in USD Million (2018–2030)

Figure 50: Market Size of CRC in France, USD Million (2018–2030)

Figure 51: Market Size of CRC by Current therapies, in France, in USD Million (2018–2030)

Figure 52: Market Size of CRC by Emerging therapies, in France, in USD Million (2018–2030)

Figure 53: Market Size of CRC in Italy, USD Million (2018–2030)

Figure 54: Market Size of CRC by Current therapies, in Italy, in USD Million (2018–2030)

Figure 55: Market Size of CRC by Emerging therapies, in Italy, in USD Million (2018–2030)

Figure 56: Market Size of CRC in Spain, USD Million (2018–2030)

Figure 57: Market Size of CRC by Current therapies in Spain, in USD Million (2018–2030)

Figure 58: Market Size of CRC by Emerging therapies in Spain, in USD Million (2018–2030)

Figure 59: Market Size of CRC in the UK, USD Million (2018–2030)

Figure 60: Market Size of CRC by Current therapies in the UK, in USD Million (2018–2030)

Figure 61: Market Size of CRC by Emerging therapies in the UK, in USD Million (2018–2030)

Figure 62: Market Size of CRC in Japan, USD Million (2018–2030)

Figure 63: Market Size of CRC by Current therapies in Japan, in USD Million (2018–2030)

Figure 64: Market Size of CRC by Emerging therapies in Japan, in USD Million (2018–2030)

Figure 65: Market Drivers

Figure 66: Market Barriers

Figure 67: Chronic Refractory Cough (CRC) SWOT Analysis

MERCK

NERRE THERAPEUTICS

BELLUS HEALTH

SHIONOGI

BAYER

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