Delirium is commonly associated with myriad conditions and requires variety of medications. Early recognition and on-time treatment can help to reduce morbidity, length of hospital stay, health care costs, and mortality in patients. According to the Marie Curie, a registered organization in the U.K. which provides nursing and hospice care to elderly patients and they have mentioned on their website that many patients develop delirium in the last few days of their life which can cause agitation or restlessness. This is sometimes called as terminal restlessness or terminal agitation. The first-generation antipsychotics are the first choice of treatment for agitation in delirium management patients, followed by second-generation antipsychotics and Benzodiazepines.
Global Agitation in Delirium Management Market - Impact of the Coronavirus (COVID-19) Pandemic
The COVID-19 pandemic is expected to drive the growth of the global agitation in delirium management market over the forecast period. According to the research carried out by researchers from the Universitat Oberta de Catalunya (UOC), published in the Journal of Clinical Immunology and Immunotherapy on November 4, 2020, symptoms like fever and increased invasive mechanical ventilation during COVID-19 increases the risks of delirium. According to the same source, the researchers also found that coronavirus disease not only damages the lungs and other organs such as the kidneys and heart but also affects the central nervous system. It produces neurocognitive alterations such as headaches, delirium, and psychotic episodes in the COVID-19 patients.
Thus, the researchers provided three hypotheses in order to explain how the coronavirus affects the central nervous system, which can lead to delirium in the COVID-19 patients. They are due to: hypoxia or neuronal oxygen deficiency, inflammation of the brain tissue due to cytokine storm, and the ability of the virus to cross the blood-brain barrier which directly affects the brain.
The global agitation in delirium management market is estimated to be valued at US$ 212.7 Mn in 2020 and is expected to exhibit a CAGR of 4.3% over the forecast period (2020-2027).
Figure 1: Global Agitation in Delirium Management Market Share (%) Analysis, By Drug, 2020
Rise in geriatric population and increasing prevalence of delirium among the elderly population is expected to drive the growth of the global agitation in delirium management market over the forecast period.
According to the World Population Ageing, 2017 report, the following graph compares the number of elderly people (in millions) in 2017 and 2050. From the graph, it can be concluded that the elderly population is expected to double in 2050 as compared to the elderly population in the year 2017. This is expected to drive growth of the global agitation in delirium management market over the forecast period.
Moreover, according to the International Journal of Advances in Medicine: 2019 report, delirium is common in older people who are admitted in hospitals and long-term care facilities, and it may indicate a life-threatening condition. According to the same source, the following table shows prevalence of delirium in percentage in elderly population during hospitalization.
|Prevalence||Percentage of patients suffering from delirium|
|Intensive care Unit (ICU)|
|With Mechanical Ventilation||60% - 80%|
|Without Mechanical Ventilation||20% - 50%|
|Community (Persons 85 years or older)||14%|
|At hospital admission||10% - 31%|
|Long-term facility and post-acute care||1% - 60%|
Therefore, increasing prevalence of delirium among the geriatric population is expected to drive growth of the global agitation in delirium management market over the forecast period.
Research institutes and market players are involved in conducting research and development activities for the management of agitation in delirium management in critically ill ICU patients, which is expected to drive the growth of the global agitation in delirium management market over the forecast period
Increasing research and development activities for testing the safety and efficacy of the drugs for the treatment of agitation in delirium management in critically ill ICU patients is expected to drive the growth of the market over the forecast period. For instance, in 2018, researchers at the Erasmus Medical Center were conducting clinical trials for studying the safety, efficacy, and pharmacokinetics of the drug Haloperidol as a first line of treatment for critically ill ICU patients suffering from delirium. The study is in Phase III and is expected to be completed by February 4, 2021.
|Base Year:||2019||Market Size in 2020:||US$ 212.7 Mn|
|Historical Data for:||2017 to 2019||Forecast Period:||2020 to 2027|
|Forecast Period 2020 to 2027 CAGR:||4.3%||2027 Value Projection:||US$ 285.4 Mn|
Teva Pharmaceutical Industries Ltd., Sun Pharmaceutical Industries Ltd., Glenmark Pharmaceuticals Limited, Mylan N.V., Fresenius Kabi AG, Novartis International AG, Akorn Incorporated, Zydus Cadila, Pfizer, Inc., and BioXcel Therapeutics, Inc.
|Restraints & Challenges:||
Government organizations are focused on creating awareness about agitation and delirium and the availability of treatment options among the patients, which is expected to drive the growth of the market over the forecast period.
Increasing awareness among the patients regarding agitation in delirium management and its management is expected to drive growth of the market over the forecast period. World Delirium Awareness Day is celebrated every year on March 17. The International Federation of Delirium Societies (iDelirium) conducts webinars in order to educate patients, caregivers, professionals, and policy makers about delirium in order to build an understanding of the global economic implications of delirium and to collaborate to advance research and development for finding solutions for the management of delirium. The table below shows other organizations, which are working to prevent the occurrence of delirium among the patients by increasing awareness.
|Delirium Care Network||By creating awareness for delirium detection, prevention, and the latest treatment options|
|Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center||Focuses on modifying the treatment for ICU patients for the treatment of delirium|
|American Delirium Society||Focuses on research, education, quality improvement, advocacy, and implementation science to minimize the impact of delirium on long-term and short-term health and wellbeing of patients|
|American Geriatrics Society (AGS)||AGS CoCare: Help is an comprehensive program, which is designed to prevent delirium for hospitalized elderly patients, it provides the relevant tools and resources to institutions so as to support its implementation|
|National Institute of Health and Care Excellence (NICE)||The organization publishes new guidelines in order to prevent delirium for those people identified at risk|
Global Agitation in Delirium Management Market – Restraints
Increasing product recalls is expected to hamper the growth of the global agitation in delirium management market over the forecast period. For instance, in 2018, Novartis International AG recalled an entire batch of antipsychotic drug Haloperidol due to packaging issue.
Moreover, the availability of non-pharmacological treatment for the management of agitation in delirium management is also expected to restrain the growth of the market. According to the guidelines provided by the Society of Critical Care Medicine and the Intensive Care Society in the UK, initially, non-pharmacological interventions are preferred for the treatment of delirium than pharmacological interventions. In 2019, Koninklijke Philips N.V. introduced a new non-pharmacological treatment for the reduction of delirium in the ICU patients. The company launched VitalMinds, an integrated multi-component solution, which is focused on providing non-pharmacological approach to reduce delirium. It consists of a unique key component VitalSky, a personalized light therapy system, which is designed for the clinical use in the intensive care unit (ICU). It improves the sleep – wake rhythm of patients. The system received CE mark and is now commercially available in Germany, Austria, Switzerland, Finland, and Sweden, with market launches planned in other European countries over the next two years.
Global Agitation in Delirium Management Market – Regional Analysis
On the basis of region, the global agitation in delirium management market is segmented into North America, Latin America, Europe, Asia Pacific, Middle East, and Africa.
The North America agitation in delirium management market is expected to hold dominant position in the market during the forecast period, owing to increasing research and development activities by key players in the U.S. For instance, on October 26th, 2020, BioXcel Therapeutics, Inc. announced that its Investigational New Drug (IND) application for BXCL501 received a clearance by the Division of Psychiatry Products of the U.S. Food and Drug Administration (FDA) for the treatment of agitation associated with delirium. Currently, the trial is in Phase II.
Furthermore, Europe is also estimated to witness significant growth in the agitation in delirium management market owing to the increasing prevalence of cancer among the European population. According to the article published in the American Cancer Society dated February 1, 2020, in case of advanced cancer, the following reasons causes delirium in cancer patients: spreading of cancer cells to the brain, side-effects of chemotherapy drugs, lack of oxygen to the brain, high fever, excessive pain medicines, and others. Moreover, according to the Organization for Economic Cooperation and Development (OECD): 2020 report, the following graph compares the percentage of different types of cancers among 1,444,949 men and 1,237,588 women in Europe.
Figure 2: Global Agitation in Delirium Management Market (US$ Mn), by Region, 2020
Global Agitation in Delirium Management Market – Competitive Landscape
Major players operating in the global agitation in delirium management market include Teva Pharmaceutical Industries Ltd., Sun Pharmaceutical Industries Ltd., Glenmark Pharmaceuticals Limited, Mylan N.V., Fresenius Kabi AG, Novartis International AG, Akorn Incorporated, Zydus Cadila, Pfizer, Inc., and BioXcel Therapeutics, Inc.
Delirium is a neurological condition which leads to disturbances in the mental abilities of a person. It causes mental confusion and emotional disruption. Delirium can be caused due to various factors such as old age, exposure to certain medications, alcohol abuse, surgery or other medical procedures and factors such as exposure to toxic or infectious agents, physical trauma, diet, and other behavioral and occupational factors. There are two types of delirium: Hyperactive delirium and Hypoactive delirium. In hyperactive delirium, patients become overactive (agitation in delirium). Currently, market players are carrying out research and development activities for evaluating new medicines for the management of agitation in delirium among the patients.
Research institutes and market players are indulged in conducting research and development activities for testing the safety and efficacy of the drugs for the treatment of agitation in delirium in critically ill ICU patients. For instance, in 2017, researchers at the University of California, San Diego, reported that sleep deprivation post-surgery causes delirium (confusion) in patients in the intensive care unit (ICU). Thus, they are conducting clinical trials for studying the role of Ramelteon, a medication that mimics the activity of melatonin (hormone which controls the body’s circadian rhythm or sleep – wake cycle) in improving the sleep quality, thus improving sleep quality is expected to help in preventing occurrence of delirium in the patients post open-heart surgery. The study is expected to be completed by December 1, 2021.
Market players are indulged in launching new first-generation antipsychotic drugs for the treatment of delirium, which is expected to spur the growth of the global agitation in delirium management market. For instance, in 2017, Lupin Limited launched Quetiapine Fumarate Extended-Release Tablets (50 mg, 150 mg, 200 mg, 300 mg and 400 mg strengths), after receiving approval from the U.S. Food and Drug Administration (U.S. FDA).
Key features of the study:
“*” marked represents similar segmentation in other categories in the respective section.