Neuromuscular Blocking Drugs Market Trends

Growth Drivers

• Product innovation by leading manufacturers: Merck & Co. increased its Bridion (Sugammadex) production facilities in partnership with the U.S. Department of Health and Human Services in 2024, surging the domestic production. At the same time, Fresenius Kabi entered multi-year distribution agreements with European public hospitals, allowing greater NMBD availability. These initiatives enhanced logistics resilience, public confidence in reversal agents, and helped each company achieve a growth in market share in the worldwide NMBD business. Further, these growths also made both companies prominent suppliers during regional NMBD shortages in Q4 2024. Additionally, increased production capacity enabled quicker response times in emergency surgical care among high-volume hospitals.
• Finished drugs and trade dynamics: As per the OEC data, the global trade of pharmaceutical products, including neuromuscular blocking drugs, reached USD 853 billion in 2023. Often, the finished drugs were reassembled in Europe and the U.S. before distribution. However, the export restriction challenges and geopolitical tensions in Asia have put pressure on improved lead times. Investing in nearshore assembly operations and diversifying API procurement are increasingly important tactics being used by multinational pharmaceutical companies. This transformation is surging companies to innovate products and establish partnerships with regional players to stabilize the supply chain and avoid future disruptions.
• Medicare & Medicaid trends in surgical demand: One in 25 people around the globe have undergone surgical procedures, as per the NLM study in May 2024. With expanded access to elective surgery and minimally invasive procedures, NMBD usage is surging in hospitals and outpatient facilities. The Centers for Medicare & Medicaid Services (CMS) predicts that increasing expenditures on perioperative medications suggest sustained NMBD demand. This reflects the increasing importance of NMBDs in improving surgical efficiency, patient safety, and postoperative recovery outcomes among U.S. healthcare institutions.

Effects of Medical Conditions on NMBAs

Source: Open Anesthesia in May 2023

Challenges

• Deficiency in regional manufacturing of API: South Africa and Brazil are the key sources to rely on the import of API, producing supply chain vulnerabilities. During the period 2021 to 2022 shipping delays, the import of API dropped and is reshaping the NMBD formulation availability in public hospitals. As per the WHO Essential Medicines Supply Chain report, the gaps in the supply chain impact the sustainable drug access mainly during trade disputes and pandemics. To overcome these risks in the future, both countries have started pubic private partnerships aimed at enhancing local API manufacturing capabilities. To protect against worldwide supply disruptions, regional health ministries are also building up strategic stocks of vital anesthetics, such as NMBDs.
• Government-regulated cost ceilings: Most of the countries have stringent price ceilings for generic drugs. In Germany and France, reference pricing restricts reimbursement amounts for NMBDs, resulting in low profit margins. In 2023, Fresenius Kabi evaded this by securing volume discounts from public hospital procurements, enhancing availability by 10%. Yet, NMBD prices in India are governed under the Drug Price Control Order (DPCO), dissuading foreign market entry because of low ROI.