DelveInsight’s ’Postoperative nausea and vomiting (PONV) - Market Insights, Epidemiology, and Market Forecast-2028’ report deliver an in-depth understanding of the disease, historical and forecasted epidemiology as well as the market trends of PONV in the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom), and Japan.
Postoperative nausea and vomiting (PONV) is an enormous problem for patients recovering after surgery. About one-third of people experience vomiting, and half of them experience nausea. Nausea, retching, or vomiting usually occurs during the first 24–48 h after surgery in inpatients. PONV is a common side effect following sedation and general anesthesia.
If these symptoms occur from 24 h following the discharge up to 72 h, it is called postdischarge nausea and vomiting (PDNV). In preoperative surveys, PONV is rated as the most likely to avoid anesthesia outcomes by the patients.
Geography Covered

  • The United States
  • EU5 (Germany, France, Italy, Spain, and the United Kingdom)
  • Japan

Study Period: 2017–2028
PONV–Disease Understanding
Postoperative nausea and vomiting (PONV) can be one of the most distressing parts of the surgical journey. It affects approximately 20–30% of patients within the first 24–48 h postsurgery. Unresolved PONV may result in prolonged postanesthesia care unit (PACU) stay and unanticipated hospital admission that results in a significant increase in overall health care costs. The goal of PONV prophylaxis is, therefore, to decrease the cases of PONV and thus patient-related distress and reduce health care costs.
PONV Epidemiology
The disease epidemiology covered in the report provides historical as well as forecasted epidemiology (Total Inpatient Surgical Cases in the 7MM, Total Number of Patients taking antiemetic treatment (prophylactic) or not taking anti-emetics in the 7MM, Total Number of Patient showing Nausea and Vomiting in the 7MM and Total Number of Post-operative Nausea and Vomiting patients in the 7MM, scenario of PONV in the 7MM covering United States, EU5 countries (Germany, France, Italy, Spain, and United Kingdom) and Japan from 2017–2028.
According to DelveInsight’s, the total inpatients surgical cases in the 7 major markets was 52,032,174 in 2017. These cases are increases with a significant CAGR during study period (2017-2028). The total PONV cases in the 7 major markets was 16,980,822 in 2017.
PONV Drug Chapters
The treatment strategy includes single and combination of the antiemetic, which works on different receptor classes that result in additive effects. The major drug classes used for prophylaxis and treatment of PONV include histamine receptor antagonists, muscarinic receptor antagonists, dopamine receptor antagonists, serotonin type 3 (5-HT3) receptor antagonists, and tachykinin 1 (NK1) receptor, antagonists.
The three therapies which are approved in the US for the management of PONV after 2000 are Aloxi, Zuplenz, and Emend. In September 2019, the PONV indication was removed from the Emend capsule as per the US prescription information; however, it remains in the labeling for generic aprepitant capsules. Other PONV drugs, which are discontinued in the US are Kytril, Phenergan, and Compazine. The generic versions of most of the therapies approved before 2000 are currently utilized for the management of PONV.
Aloxi is an intravenous palonosetron hydrochloride injection developed by Eisai Corporation of North America, its US subsidiary MGI Pharma, and Helsinn Healthcare. In February 2008, the US FDA approved Aloxi IV injection for the prevention of PONV for up to 24 h following surgery. In phase III clinical study the most frequently observed side effects with Aloxi were electrocardiogram (ECG) QT prolongation (five percent), bradycardia (four percent), headache (three percent), and constipation (two percent) (Eisai Corporation, 2008).
Zuplenz is an oral soluble film containing ondansetron in 4 mg and 8 mg strength. In July 2011, it was approved in the US for the prevention of PONV. The patents of Aloxi and Zuplenz will expire in 2024 and 2030, respectively.
Post-Operative Nausea and Vomiting (PONV) Market Outlook
The market size of PONV in the seven major markets (7MM) was USD 1,890.53 million in 2017. In addition, the Prophylactic and Rescue treatment market size of PONV in the seven major markets (7MM) was USD 1,272.81 million and USD 617.72 million in 2017.

Post-Operative Nausea and Vomiting (PONV) Drugs Uptake
There are only a few companies that are working for the management of PONV, and that includes Acacia Pharma (Barhemsys), Cara Therapeutics (CR845), Braeburn Pharmaceuticals, and Camurus.
Barhemsys (formerly known as APD421 and Baremsis) is an intravenous formulation of amisulpride, a selective small-molecule dopamine antagonist, which has completed phase III clinical development for the prophylaxis and treatment of PONV, alone and in combination with other antiemetic.
CR845 (also known as difelikefalin) which is under development by Cara is an analgesic opioid peptide acting as a peripherally specific, highly selective agonist of the kappa opioid receptor. It is currently investigated in phase II/III clinical study for the management of PONV.
PONV Report Insights

  • Patient Population by total Inpatient Surgical cases
  • Total PONV cases
  • Therapeutic Approaches
  • Pipeline Analysis
  • Market Size and Trends
  • Market Opportunities
  • Impact of upcoming Therapies

PONV Report Key Strengths

  • 10 Year Forecast
  • 7MM Coverage
  • Epidemiology Segmentation
  • Drugs Uptake
  • Highly Analyzed Market
  • Key Cross Competition

PONV Report Assessment

  • Current Treatment Practices
  • Unmet Needs
  • Detailed Pipeline Product Profiles
  • Market Attractiveness
  • Market Drivers and Barriers

Key benefits

  • This DelveInsight report will help to develop Business Strategies by understanding the trends shaping and driving the PONV market
  • Organize sales and marketing efforts by identifying the best opportunities for PONV market
  • To understand the future market competition in the PONV market.