Thesis (MBA)--Stellenbosch University, 2012. / Analgesics are the medication most-generally used by modern society. The pain management market has therefore experienced substantial growth over the last few years. This research report aims to provide a critical review of pain management in the pharmaceutical market in South Africa, in order to establish and evaluate the most significant growth factors. This research report provides an overview of the history of pain, the basic physiology of pain and pain classification systems. There are three categories of analgesics - opioid analgesics, non-opioid analgesics and adjuvant analgesics. These categories of analgesics have been analysed according to the most generally-used MIMS pharmacological classification system referring to the analgesic therapeutic classes. These are narcotic analgesics, analgesics and antipyretics, combination analgesics, others such as tramadol and musculo-skeletal agents which consist of NSAIDs and COX inhibitors. Growth over the last four years (from August 2009 to July 2012) will be determined by analysing data per molecule, per product and per manufacturer. Splits between branded and generic drugs will also be analysed. Top prescribers by healthcare professionals will be examined, analysing scripting data from ImpactRx, which covers 85% of the private market data nationally. There are currently approximately 41 analgesic molecules in the assessed pain market which has produced 738 analgesic products. The analgesic market (worldwide and in South Africa) has seen the launch of only a few new drugs. New molecules of the same drug class or family have been launched, but in effect they can be viewed as mere line extensions with claimed reduction in side effects, advanced delivery times or improved efficacy. Two new molecules have been launched in the South African market in the narcotic analgesic class, (oxycodone and hydromorphone), however these molecules have been available internationally for years. Accelerated growth of the pain management market has mainly been met by combination analgesics, which in essence are not new, but rather a combination of different active ingredients or new drug delivery systems. The impact of product withdrawals on market share is also evaluated. The development and acceptance of generics are highlighted as key contributing factors in the growth of the analgesic market. Important to note is that generics often compete in their own generic market share. This may be the reason why the generic market does not show a significant increase over branded products. Another significant trend evident in the increased acceptance of generics, is that manufacturers, in order to keep market share, may choose to produce their own generic medication after their branded products patent has expired. Pain is one of the main reasons why patients seek medical attention and it is the physician’s ethical responsibility to treat patients and provide them with effective pain relief medication. The WHO analgesic ladder as a guideline for treating pain has proven to be effective after 25 years in practice. It is forecasted that an increase in the narcotic analgesic class will be noted. Pain is heavily undertreated worldwide and in South Africa, Increased awareness, education, new advanced research and knowledge may help to address this dilemma.