King Pharmaceuticals, Inc. / Alpharma Inc.

Chronic Pain (Opioid & Non-Opioid Analgesia)

Disease Overview

Chronic pain affects roughly 22% of US adults (~55M people) and is treated across a tiered analgesic ladder including NSAIDs, topical agents, and long-acting opioids for moderate-to-severe persistent pain. The 2008-2010 period predated the full force of the opioid crisis but already raised abuse-deterrent and divertibility concerns at FDA.

Competitive Landscape

In late 2008, the long-acting opioid market was led by Purdue's OxyContin (oxycodone ER), with morphine sulfate ER competition between Kadian (Alpharma, once-daily) and Avinza (King, once-daily morphine ER acquired from Ligand in 2007), plus generic MS Contin. The Flector Patch (diclofenac epolamine, topical NSAID) was a differentiated non-opioid acute pain franchise from Alpharma. Embeda (morphine sulfate/naltrexone HCl ER capsules) was an investigational abuse-deterrent reformulation under FDA priority review at deal close, expected to launch Q1 2009. The FTC required King to divest Kadian to Actavis for $127.5M within 10 days of closing, on the basis that King's Avinza and Alpharma's Kadian were the only two competitively significant branded morphine sulfate oral long-acting opioids in the US. King retained Avinza, Embeda, and Flector. The deal also brought Alpharma's animal-health livestock division. Strategically, the transaction made King a leading branded pain franchise, but the abuse-deterrent thesis behind Embeda underperformed and Pfizer acquired King two years later for $3.6B in 2010.