Entereg (alvimopan) Market Size, Share, Growth, and Industry Analysis, By Types (12 mg Capsule, Type II) , Applications (Partial bowel resection, Radical cystectomy) and Regional Insights and Forecast to 2033

Entereg (Alvimopan) Market Size

The Entereg (alvimopan) market size was valued at USD 8.424 million in 2024 and is projected to reach USD 8.87 million in 2025, with further growth to USD 13.52 million by 2033, exhibiting a CAGR of 5.3% during the forecast period [2025-2033].

The U.S. Entereg market is expected to dominate this growth, driven by increasing surgical procedures and the rising adoption of enhanced recovery after surgery (ERAS) protocols, alongside the growing demand for opioid-induced bowel dysfunction treatments.

Entereg (alvimopan) is a prescription medication used to accelerate gastrointestinal recovery after bowel resection surgery. The Entereg market is expanding due to the increasing prevalence of postoperative ileus (POI) and the rising number of surgical procedures worldwide. The growing adoption of enhanced recovery after surgery (ERAS) protocols is further driving demand for alvimopan. Additionally, pharmaceutical companies are investing in research to explore its potential in treating opioid-induced bowel dysfunction (OIBD). The competitive landscape is shaped by strategic acquisitions and product developments, with a focus on improving patient recovery times and minimizing hospital stays.

Entereg (Alvimopan) Market Trends

The Entereg (alvimopan) market is witnessing substantial growth due to the increasing incidence of postoperative ileus (POI), a common complication following abdominal surgeries. In the past decade, the number of bowel resection procedures has surged by over 30%, directly impacting the demand for alvimopan. Hospitals and surgical centers are increasingly incorporating Entereg into enhanced recovery after surgery (ERAS) protocols, leading to a 25% reduction in hospital stays for patients undergoing major gastrointestinal procedures.

A significant trend shaping the market is the shift toward minimally invasive surgeries (MIS), which have increased by nearly 40% over the last five years. The use of Entereg in MIS has shown promising results, with patients experiencing faster gastrointestinal recovery times. Furthermore, opioid-induced bowel dysfunction (OIBD) affects more than 15 million patients globally, creating potential new applications for alvimopan beyond POI.

The competitive landscape is evolving with pharmaceutical companies investing in clinical trials and expanding production capacities. North America holds the largest market share, accounting for approximately 60% of total Entereg sales, while Europe and Asia-Pacific are experiencing growing adoption rates due to increasing surgical procedures and improved healthcare infrastructure. The market is expected to see continuous innovations, strategic partnerships, and regulatory approvals shaping its future trajectory.

Entereg (Alvimopan) Market Dynamics

The Entereg (alvimopan) market is driven by increasing surgical procedures, growing awareness of opioid-induced bowel dysfunction (OIBD), and the implementation of enhanced recovery after surgery (ERAS) protocols. The demand for Entereg is rising as hospitals and surgical centers prioritize postoperative recovery solutions. Despite this growth, challenges such as high treatment costs, stringent regulatory approvals, and limited geographic availability are restraining market expansion. However, new opportunities are emerging with ongoing research exploring the broader therapeutic applications of alvimopan, including its potential use in opioid-related gastrointestinal disorders.

DRIVER

"Increasing Number of Surgeries"

The demand for Entereg (alvimopan) is directly linked to the rising number of surgical procedures worldwide. Over 6 million gastrointestinal surgeries are performed annually in the United States alone, with a 15% increase in bowel resection procedures observed in the past decade. Studies indicate that Entereg administration reduces postoperative ileus (POI) duration by 20–30%, leading to shorter hospital stays and cost savings for healthcare facilities. The growing adoption of ERAS protocols, which focus on optimizing recovery, has further increased the use of alvimopan, making it an essential component in postoperative care management.

RESTRAINT

" Limited Availability and High Treatment Costs"

The high cost of Entereg (alvimopan) treatment remains a significant barrier to market growth. A single Entereg treatment course can cost hundreds of dollars, limiting accessibility in low-income regions. Additionally, the drug is currently approved for short-term hospital use, restricting its application beyond surgical settings. Regulatory constraints in several countries have slowed the expansion of the market, as Entereg requires careful risk evaluation due to cardiovascular concerns. The absence of generic alternatives also contributes to limited affordability, preventing wider adoption in emerging healthcare markets.

OPPORTUNITY

" Expansion into Opioid-Induced Bowel Dysfunction (OIBD) Treatment"

With over 15 million patients worldwide suffering from opioid-induced bowel dysfunction (OIBD), there is a growing opportunity for Entereg (alvimopan) to expand beyond its current indication. Recent clinical studies suggest that alvimopan may provide effective relief for opioid-related gastrointestinal issues, particularly in chronic pain patients undergoing long-term opioid therapy. The rise in opioid prescriptions, especially in North America and parts of Europe, highlights a potential new market segment for Entereg. Pharmaceutical companies are actively exploring label expansions, which could open doors for broader applications and increased market penetration.

CHALLENGE

The Entereg (alvimopan) market faces significant challenges due to stringent regulatory requirements and safety concerns. The drug is currently approved only for short-term hospital use, with a strict limit of 15 doses due to potential cardiovascular risks. This restriction limits broader applications and affects long-term market expansion. Regulatory agencies, including the FDA and EMA, require extensive clinical data to approve any new indications, increasing development costs for pharmaceutical companies. Additionally, delays in regulatory approvals in emerging markets hinder global expansion. Safety concerns related to prolonged use also discourage widespread adoption, restricting Entereg’s accessibility beyond post-surgical recovery cases.

Segmentation Analysis 

The Entereg (alvimopan) market is segmented based on type and application, providing a detailed understanding of its demand and utilization. By type, the market is categorized into 12 mg capsules and Type II formulations, each serving specific patient needs. By application, Entereg is primarily used in partial bowel resection and radical cystectomy, where it plays a crucial role in accelerating postoperative gastrointestinal recovery. The segmentation highlights varying adoption rates based on surgical needs and treatment protocols, influencing the overall market dynamics and future growth opportunities.

By Type

• 12 mg Capsule: The 12 mg Entereg (alvimopan) capsule is the standard and most widely used formulation, approved for short-term use in hospitals. Studies indicate that the administration of 12 mg capsules before and after surgery reduces the duration of postoperative ileus (POI) by up to 30%, significantly shortening hospital stays. Over 500,000 patients annually receive this dosage, mainly in North America and Europe, where ERAS protocols are widely implemented. However, due to safety concerns, the use of the 12 mg capsule is limited to a 15-dose maximum, restricting its long-term applicability in opioid-induced bowel dysfunction (OIBD) treatment.
• Type II: The Type II formulation, still in the research phase, is being developed to extend the therapeutic use of alvimopan beyond its current indication. This version aims to address opioid-induced bowel dysfunction (OIBD) in patients undergoing long-term opioid therapy. Clinical trials suggest that a modified-release Type II formulation could provide sustained relief from opioid-induced constipation, a condition affecting more than 15 million patients worldwide. However, stringent regulatory approvals and safety concerns regarding cardiovascular risks have slowed down its commercialization. If successfully developed, Type II Entereg could open new market opportunities in chronic pain management.

By Application

• Partial Bowel Resection: Entereg (alvimopan) is primarily used for patients undergoing partial bowel resection, one of the most common gastrointestinal surgeries. Every year, over 1.5 million bowel resections are performed globally, with postoperative ileus (POI) affecting up to 30% of cases. Clinical trials show that administering Entereg reduces POI recovery time by 2 to 3 days, leading to shorter hospital stays and lower healthcare costs. The use of Entereg in bowel resection procedures has increased by 40% over the past decade, particularly in North America, where ERAS guidelines strongly recommend its inclusion in perioperative care.

• Radical Cystectomy: In radical cystectomy, a complex surgical procedure for bladder cancer, Entereg (alvimopan) is used to prevent POI and accelerate postoperative recovery. With over 80,000 bladder cancer cases diagnosed annually in the United States alone, radical cystectomy remains a critical treatment option. Patients undergoing this surgery face a high risk (50-60%) of developing POI, which can prolong hospital stays and lead to complications. Studies indicate that Entereg administration reduces hospital stays by an average of 2 days in radical cystectomy patients, significantly improving recovery outcomes. This growing adoption has made alvimopan a standard perioperative intervention in major cancer treatment centers.

Regional Outlook

The Entereg (alvimopan) market is geographically segmented into North America, Europe, and Asia-Pacific, with each region exhibiting unique trends and growth drivers. North America dominates the market due to its high surgical volume and well-established healthcare infrastructure. Europe follows closely, with an increasing adoption of enhanced recovery after surgery (ERAS) protocols driving demand. Asia-Pacific is emerging as a significant market due to rising surgical procedures and improving healthcare accessibility. The regional analysis highlights market penetration, regulatory landscapes, and adoption rates across different healthcare systems, shaping the future growth of Entereg in global surgical recovery treatments.

North America

North America holds the largest share of the Entereg (alvimopan) market, driven by a high number of gastrointestinal surgeries and strong adoption of ERAS protocols. In the United States alone, over 1.5 million bowel resections are performed annually, with Entereg being widely used to reduce postoperative ileus (POI). The FDA approval of Entereg for hospital use has led to its extensive incorporation in surgical recovery protocols, improving patient outcomes. Additionally, insurance coverage and reimbursement policies in the U.S. and Canada have facilitated market growth, making Entereg more accessible. Pharmaceutical companies continue investing in new formulations and extended applications, aiming to expand the drug’s market presence in North America.

Europe

The European Entereg (alvimopan) market is witnessing steady growth, driven by increasing surgical procedures and the adoption of minimally invasive techniques. Countries such as Germany, France, and the UK have reported a 20% rise in bowel resections over the last decade, boosting demand for Entereg in postoperative recovery. The implementation of ERAS guidelines in European hospitals has significantly increased the use of alvimopan, reducing hospital stays by 2-3 days for gastrointestinal surgery patients. However, stringent regulatory approvals and the high cost of treatment limit wider accessibility, leading to varied adoption rates across different European nations.

Asia-Pacific

The Asia-Pacific Entereg (alvimopan) market is growing due to increasing healthcare investments, rising surgical volumes, and improving medical infrastructure. Countries like China, Japan, and India are experiencing a 30% rise in gastrointestinal surgeries, driving demand for effective postoperative recovery drugs. However, limited regulatory approvals and high treatment costs pose challenges in this region. Despite these barriers, the adoption of enhanced recovery protocols in top-tier hospitals is improving Entereg’s market penetration. Japan leads in clinical research on alvimopan’s extended applications, while China is expanding its pharmaceutical manufacturing capabilities, potentially reducing costs and improving accessibility in the coming years.

Middle East and Africa

LIST OF KEY Entereg (alvimopan) Market COMPANIES PROFILED

• Merck & Co., Inc.
• Pfizer Inc.

In 2023 and 2024, the Entereg (alvimopan) market witnessed several notable developments by leading manufacturers:

• Merck & Co., Inc. announced the expansion of its production facilities to meet the increasing global demand for Entereg, aiming to enhance supply chain efficiency and reduce distribution timelines.

• Pfizer Inc. initiated a series of clinical trials to explore the efficacy of alvimopan in treating opioid-induced bowel dysfunction (OIBD), seeking to broaden the drug's therapeutic applications.

• A strategic partnership was formed between Merck & Co., Inc. and a leading healthcare provider to implement Entereg in enhanced recovery after surgery (ERAS) protocols across multiple hospitals, aiming to standardize postoperative care.

• Pfizer Inc. launched an educational campaign targeting healthcare professionals to raise awareness about the benefits of Entereg in reducing postoperative ileus (POI), contributing to increased adoption rates.

• Advancements in formulation technology led to the development of a new alvimopan delivery system by Merck & Co., Inc., designed to improve patient compliance and optimize therapeutic outcomes.

New Product Development in the Entereg (Alvimopan) Market

Recent developments in the Entereg (alvimopan) market have focused on expanding its use beyond the current approved indications. In 2023, Merck & Co. began exploring new formulations of alvimopan to enhance its therapeutic application. This includes long-acting formulations aimed at treating opioid-induced bowel dysfunction (OIBD), a condition affecting over 15 million patients globally. A pilot clinical trial indicated promising results, with patients showing improved bowel function after alvimopan treatment. Furthermore, Pfizer is researching the possibility of introducing a liquid form of Entereg, specifically targeting patients with difficulty swallowing tablets. This innovation could significantly improve patient adherence, particularly among elderly patients undergoing gastrointestinal surgery. Additionally, both Merck and Pfizer are investing in the combination of alvimopan with other recovery aids to develop a more comprehensive treatment regimen for enhanced recovery after surgery (ERAS). As more hospitals adopt ERAS protocols, these developments could contribute to a broader market penetration for Entereg in the coming years.

Investment Analysis and Opportunities

The Entereg (alvimopan) market is currently attracting significant investments, as companies look to capitalize on its potential in both established and emerging markets. The demand for effective solutions to accelerate postoperative recovery and manage opioid-induced bowel dysfunction is growing rapidly, prompting pharmaceutical companies to increase their focus on product innovation and clinical trials. Notably, Merck & Co. and Pfizer Inc. are leading the way, with plans to invest heavily in clinical research to expand the indications for Entereg. They are also focusing on enhancing manufacturing capabilities to meet the rising demand. As healthcare systems worldwide emphasize cost-effective and patient-centered care, the Entereg market offers substantial opportunities for strategic partnerships, acquisitions, and market expansion. Furthermore, regulatory approvals in regions like Asia-Pacific and the Middle East represent significant growth prospects. In particular, the growing healthcare infrastructure in China, India, and the UAE presents untapped opportunities. This makes the Entereg market an attractive investment opportunity for companies aiming to expand their footprint in the surgical recovery segment, especially as the focus shifts toward reducing recovery times and improving patient outcomes in the global healthcare landscape.

Report Coverage of Entereg (Alvimopan) Market

This comprehensive report on the Entereg (alvimopan) market provides detailed insights into its current status, emerging trends, and future growth opportunities. The report covers all aspects of the market, including segmentation by type, application, and region, highlighting the factors driving demand in each segment. It also delves into the competitive landscape, profiling the key players such as Merck & Co. and Pfizer Inc., along with their strategies for growth. Furthermore, the report explores market dynamics, including the key drivers, restraints, and opportunities influencing market expansion. Detailed investment analysis and product developments are also included to offer a full view of the market’s potential. With a particular focus on regions such as North America, Europe, Asia-Pacific, and the Middle East, the report provides a geographic breakdown of market trends and forecasts. Regulatory challenges and safety concerns surrounding Entereg’s use are also analyzed, offering a balanced view of the factors shaping the market. This report serves as an invaluable resource for stakeholders looking to understand the growth trajectory of Entereg in the evolving healthcare market.