General Anesthesia (Europe)


Based on a market research, PAION estimates that in the EU, approximately 29 million procedures requiring general anesthesia are performed each year. Of these, approximately 10 million are performed for high-risk patients (American Society of Anesthesiologists (“ASA”) classifications III or higher) who are particularly prone to hemodynamic instability. 55% of all anesthesias are balanced anesthesia (a combination of intravenous agents for induction and volatile gases for maintenance), 20% are total intravenous anesthesias (“TIVA”) using Propofol, and the remaining 25% include regional anesthesia (for example epidural administration). Based on PAION’s own EU market research, the current standard-of-care drugs for general anesthesia are Propofol (especially for induction) and narcotic gases; in each case in conjunction with intravenous opioids.

Patient demographics in the EU continue to evolve driven by the aging population. PAION anticipates an increasing number and complexity of medical interventions requiring induction and maintenance of anesthesia in the future driven by an ongoing evolution of the demographic profile in the EU. While general anesthesia is more frequently offered to elderly patients than in the past, the choice is an individual one depending on the type of surgery, the underlying disease, and assessment of the general physical health of the patient, including co-morbidities.

Accordingly, PAION believes that demand for safer agents with low respiratory and cardio-depressive effects will increase over the coming years, creating opportunities for anesthetics with an enhanced safety profile such as remimazolam, even at higher prices compared to existing generic drugs.