Drug Resistant Epilepsy Market

• Drug-Resistant Epilepsy (DRE), also referred to as refractory epilepsy, is identified when seizures continue despite the use of two suitable and well-tolerated anti-seizure medications. It occurs in approximately one-third of individuals with epilepsy, highlighting the persistence of seizures even after standard medication trials.
• A 2024 real-world analysis in the UK estimated that the prevalence of DRE was 26.6%. It also highlighted a significant disease burden among individuals with DRE.
• The rise in DRE cases in the US is attributed to increased epilepsy prevalence, improved diagnosis, longer life expectancy, and better awareness. These factors contribute to identifying more patients who fail to respond to standard anti-seizure medications.
• Vagus Nerve Stimulation (VNS) is FDA-approved for DRE, offering non-pharmacologic seizure control. This underscores an urgent need for novel antiepileptic drugs with improved mechanisms of action and better tolerability to enhance outcomes and personalize DRE management strategies
• Several companies are advancing therapies for DRE, including Neurona Therapeutics with NRTX-1001, IAMA Therapeutics with IAMA-6 among others. These innovative treatments target unmet clinical needs and offer promising efficacy. Regulatory approval of such therapies could significantly expand the DRE treatment landscape, drive market growth, and generate substantial revenue through improved patient outcomes and broader adoption.
• Current treatments for DRE offer limited seizure control in many patients, underscoring the need for advanced therapies with improved efficacy and tolerability. The market continues to seek innovative solutions that can address persistent seizures where standard medications fall short.

DelveInsight’s comprehensive report titled “Drug-Resistant Epilepsy (DRE) — Market Insights, Epidemiology, and Market Forecast – 2034” offers a detailed analysis of DRE. The report presents historical and projected epidemiological data covering diagnosed prevalent cases of epilepsy, diagnosed prevalent cases of DRE, type-specific diagnosed prevalent cases of DRE and gender-specific diagnosed prevalent cases of DRE. In addition to epidemiology, the market report encompasses various aspects related to the patient population. These aspects include the diagnosis process, prescription patterns, physician perspectives, market accessibility, treatment options, and prospective developments in the market across 7MM: the United States, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan, spanning from 2020 to 2034.

The report analyzes the existing treatment practices and unmet medical requirements in DRE. It evaluates the market potential and identifies potential business prospects for enhancing therapies or interventions. This valuable information enables stakeholders to make well-informed decisions regarding product development and strategic planning for the market.

Drug-Resistant Epilepsy (DRE) Overview

DRE, also known as intractable or refractory epilepsy, refers to the inability to achieve sustained seizure freedom despite adequate trials of two well-tolerated, correctly selected antiepileptic drugs—either alone or in combination. DRE may arise from poor treatment adherence, incorrect drug choice or dosage, or misdiagnosis, such as nonepileptic seizures resembling epilepsy. Risk factors for progression to DRE include early-onset epilepsy, intellectual disability, symptomatic causes, and abnormal neurological findings. Epilepsy itself can stem from brain injury, developmental structural abnormalities, or genetic influences. A single seizure from causes like high fever or head trauma does not equate to DRE. It is only diagnosed after two or more unprovoked seizures. Seizures are broadly classified into generalized onset, focal onset, and unknown onset types, each with further subdivisions. Understanding these distinctions is vital for accurate diagnosis and treatment planning.

Drug-Resistant Epilepsy (DRE) Diagnosis and Treatment Overview 

DRE involves a comprehensive approach, beginning with neurological examination and brain imaging techniques such as Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) scans to detect structural abnormalities like tumors or hemorrhages. Seizure classification also plays a critical role in guiding diagnosis. Once DRE is identified—typically after two ineffective Automated External Defibrillator (AED) trials—treatment pivots to more specialized strategies.

Management includes pharmacotherapy, often with Sodium Channel Modulators or Synaptic Vesicle Glycoprotein 2A (SV2a) vesicle inhibitors, though success is limited with additional AEDs. Surgical intervention may be considered for localized seizure foci. Alternative therapies such as neurostimulation, ketogenic diets, and lifestyle modifications offer additional avenues. Agents like phenytoin and carbamazepine remain standard options—phenytoin modulates sodium channels post-depolarization, while carbamazepine’s carbamyl moiety is vital for its anticonvulsant effects. A tailored, multidisciplinary approach is essential for optimizing outcomes in DRE patients.

Drug-Resistant Epilepsy (DRE) Epidemiology

The epidemiology section of the DRE market report offers information on the patient populations, including historical and projected trends for each of the 7MM. Examining Key Opinion Leader (KOL) views from physicians or clinical experts can assist in identifying the reasons behind historical and projected trends. The diagnosed patient pool, their trends, and the underlying assumptions are all included in this section of the report.

This section also presents the data with relevant tables and graphs, offering a clear and concise view of the prevalence of DRE. Additionally, the report discloses the assumptions made during the analysis, ensuring data interpretation and presentation transparency. This epidemiological data is valuable for understanding the disease burden and its impact on the patient population across various regions.

Key Findings

• According to the secondary analysis, DRE affects approximately one-third of the epilepsy patients in the 7MM. Several factors were linked to a higher likelihood of developing DRE, such as an early age of seizure onset, epilepsy caused by an identifiable structural or metabolic cause (symptomatic epilepsy), abnormal findings on brain scans or EEG tests, intellectual disability, neuropsychiatric conditions, a history of febrile seizures, and episodes of status epilepticus.
• A retrospective cohort study reported that the prevalence of focal DRE ranged from 8.8% in Italy and 18.2% in Germany.
• A US study found that during a one-year follow-up, women were 27% more likely than men to develop treatment-resistant epilepsy, regardless of age.

Drug-Resistant Epilepsy (DRE) Market Outlook

The DRE therapeutics market is further expected to increase by the major drivers, such as the rising prevalent population, technological advancements, and upcoming therapies in the forecast period (2025–2034).

DRE presents ongoing therapeutic challenges, impacting nearly one-third of individuals with epilepsy. While no drug based therapies are specifically approved for DRE, several antiseizure medications—such as clobazam, perampanel, cenobamate, and the recently introduced XEN1101—are used in cases where conventional options fail. For individuals unresponsive to these treatments, alternatives include off-label use of agents like felbamate and vigabatrin, dietary approaches such as the ketogenic diet, and neuromodulation techniques like VNS and responsive neurostimulation (RNS). Surgical resection may be considered for focal epilepsy. Continued development of more targeted and well-tolerated options remains a key focus of current research.

With ongoing research and continued dedication, the future holds hope for even more effective treatments and, ultimately, a cure for this challenging condition. According to DelveInsight, the DRE market in the 7MM is expected to change significantly during the forecast period (2025–2034).

Drug-Resistant Epilepsy (DRE) Drug Chapters 

Marketed Drugs

Vagus Nerve Stimulation (VNS) Therapy: LivaNova 

VNS Therapy, developed by LivaNova, is an established neuromodulation treatment specifically designed for individuals with DRE, particularly those experiencing partial or generalized seizures who are not candidates for resective brain surgery.

• In June 2025, LivaNova took a strategic step by beginning the formal process with the US Centers for Medicare and Medicaid Services (CMS) to revisit and potentially expand Medicare coverage of its VNS Therapy—this time aiming to include individuals with unipolar treatment-resistant depression.

• In June 2017, the US FDA expanded approval of VNS Therapy to include children as young as four with partial-onset seizures unresponsive to medication—making it the first and only device approved for pediatric Drug-Resistant Epilepsy. Prior to this, it was only approved for patients aged 12 and older.

Note: Detailed marketed therapies assessment will be provided in the final report.

Emerging Drugs

NRTX-1001: Neurona Therapeutics

NRTX-1001 is derived from human stem cells that are engineered into interneurons, similar to those naturally found in the brain. These cells release GAMMA-AMINOBUTYRIC ACID (GABA), a key neurotransmitter believed to help suppress seizure activity by inhibiting excessive neural signaling.

• In June 2025, Neurona Therapeutics reported that it had dosed the first patient in its Phase I/II clinical trial evaluating NRTX-1001, a regenerative cell therapy, in adults with drug-resistant, bilateral mesial temporal lobe epilepsy (MTLE).

• In April 2025, Neurona Therapeutics shared fresh results from their early-stage clinical trial of NRTX-1001, an experimental treatment for adults with drug-resistant MLTE. The data was presented at this year’s American Academy of Neurology, offering a glimpse into potential progress for patients with limited treatment options.

IAMA-6: IAMA Therapeutics 

IAMA-6, an orally administered small molecule therapeutics, is designed to selectively inhibit NKCC1 and restore neuronal excitability. The elevated activity of NKCC1 is implicated in various pathological conditions, underscoring the significant potential of NKCC1 inhibition in the treatment of refractory epilepsy, and other neurological disorders.

• The company has successfully completed a first-in-human Phase I clinical study (NCT06300398), which demonstrated that IAMA-6 is safe and well tolerated in healthy volunteers, with a favorable pharmacokinetic profile.

Note: Detailed marketed therapies assessment will be provided in the final report.

Drug-Resistant Epilepsy (DRE) Market Segmentation

DelveInsight’s ‘Drug-Resistant Epilepsy (DRE) – Market Insights, Epidemiology, and Market Forecast – 2034’ report provides a detailed outlook of the current and future DRE market, segmented within countries, by therapies, and by classes. Further, the market of each region is then segmented by each therapy to provide a detailed view of the current and future market share of all therapies. 

Drug-Resistant Epilepsy (DRE) Market Size by Countries

The DRE market size is assessed separately for various countries, including the United States, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan. In 2024, the United States held a significant share of the overall 7MM DRE market, primarily attributed to the country’s higher prevalence of the condition and the elevated cost of the available treatments. This dominance is projected to persist, especially with the potential early introduction of new products.

Drug-Resistant Epilepsy (DRE) Market Size by Therapies

DRE Market Size by Therapies is categorized into current and emerging markets for the study period 2020–2034. 

Drug-Resistant Epilepsy (DRE) Drugs Uptake

This section focuses on the sales uptake of potential DRE drugs that have recently been launched or are anticipated to be launched in the DRE market between 2020 and 2034. It estimates the market penetration of DRE 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 probability of success (PoS) of the drugs in the DRE market.

The emerging DRE therapies are analyzed based on various attributes such as safety and efficacy in randomized clinical trials, order of entry and other market dynamics, and the unmet need they fulfill in the DRE market.

Note: Detailed assessment of drug uptake and attribute analysis will be provided in the full report on DRE.

Drug-Resistant Epilepsy (DRE) Market Access and Reimbursement

DelveInsight’s ‘Drug-Resistant Epilepsy (DRE) – Market Insights, Epidemiology, and Market Forecast – 2034’ report provides a descriptive overview of the market access and reimbursement scenario of DRE. 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. 

Key Opinion Leader (KOL) Views

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

Drug-Resistant Epilepsy (DRE): KOL Insights

DelveInsight’s analysts connected with 20+ KOLs to gather insights; however, interviews were conducted with 10+ KOLs in the 7MM. These KOLs were from organizations, institutes, and hospitals, such as, CDC, National Center for Chronic Disease Prevention and Health Promotion, US, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Hospices Civils De Lyon and University of Lyon, Lyon, France; Sapienza University, Rome, Italy; Hospital Universitario Virgen de la Arrixaca, Murcia, Spain; University of Sheffield, UK; Hiroshima University Hospital, Japan, among others.

"As per KOL from the US, DRE poses significant challenges due to its complex nature, making it difficult to manage with conventional antiepileptic drugs. The condition often leads to frequent and severe seizures, adversely affecting patients' quality of life. Moreover, the lack of effective treatment options and the unpredictability of seizures contribute to the burden on patients and healthcare systems." 

"As per KOL from the UK, treatment for DRE typically involves a combination of multiple antiepileptic drugs, but success rates are often low. Surgical interventions, like resective surgery or neuromodulation techniques (e.g., vagus nerve stimulation), offer alternatives when medication fails. Emerging therapies, such as gene therapy and novel pharmacological agents, are under investigation to provide more effective and targeted treatment options." 

"As per KOL from Japan, significant unmet needs remain in DRE management, including the development of more effective and less invasive treatments. Improved diagnostic tools to identify DRE earlier and more accurately are crucial. Additionally, there is a need for personalized medicine approaches to tailor treatments to individual patients, reducing the trial-and-error process currently prevalent in DRE management.”

Note: Detailed assessment of KOL Views will be provided in the full report on DRE.

Competitive Intelligence Analysis

We conduct a Competitive and Market Intelligence analysis of the DRE. Market, utilizing various competitive intelligence tools such as SWOT analysis and Market entry strategies. The inclusion of these analyses is contingent upon data availability, ensuring a comprehensive and well-informed assessment of the market landscape and competitive dynamics.

Drug-Resistant Epilepsy (DRE) Pipeline Development Activities

The report offers an analysis of therapeutic candidates in Phase II and III stages and examines companies involved in developing targeted therapeutics for DRE. It provides valuable insights into the advancements and progress of potential treatments in clinical development for this condition.

Pipeline Development Activities

The report covers information on collaborations, acquisition and merger, licensing, patent details, and other information for emerging DRE therapies.

Drug-Resistant Epilepsy (DRE) Report Insights

• DRE Patient Population
• Therapeutic Approaches
• DRE Pipeline Analysis
• DRE Market Size and Trends
• DRE Market Opportunities
• Impact of Upcoming Therapies

Drug-Resistant Epilepsy (DRE) Report Key Strengths

• 10 Years Forecast
• The 7MM Coverage
• DRE Epidemiology Segmentation
• Key Cross Competition
• Highly Analyzed DRE Market
• DRE Drugs Uptake

Drug-Resistant Epilepsy (DRE) Report Assessment

• DRE Current Treatment Practices
• Unmet Needs
• DRE Product Profiles
• DRE Market Attractiveness

Key Questions

• How common is DRE?
• What are the key findings of DRE epidemiology across the 7MM, and which country will have the highest number of patients during the study period (2020–2034)?
• What are the currently available treatments for DRE?
• What are the disease risk, burden, and unmet needs of DRE?
• At what CAGR is the DRE market and its epidemiology is expected to grow in the 7MM during the forecast period (2025–2034)?
• How would the unmet needs impact the DRE market dynamics and subsequently influence the analysis of the related trends?
• What would be the forecasted patient pool of DRE in the 7MM covering the United States, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan?
• Among EU4 and the UK, which country will have the highest number of patients during the forecast period (2025–2034)?
• How many companies are currently developing therapies for the treatment of DRE?

Reasons to buy

• The report will help in developing business strategies by understanding the latest trends and changing treatment dynamics driving the DRE market.
• Insights on patient burden/disease prevalence, evolution in diagnosis, and factors contributing to the change in the epidemiology of the disease during the forecast years.
• To understand the existing 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 current treatment in the US, EU4 (Germany, France, Italy, and Spain), the UK, and Japan.
• Identification of strong upcoming players in the 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 attribute analysis section to provide visibility around leading classes.
• Highlights of market access and reimbursement policies of approved therapies, barriers to accessibility of off-label expensive therapies, and patient assistance programs.
• To understand the perspective of KOL around the accessibility, acceptability, and compliance-related challenges of existing treatment to overcome barriers in the future.
• Detailed insights on the unmet needs of the existing market so that the upcoming players can strengthen their development and launch strategy.