Despite efforts to maximize the utility of existing pain medicines, obvious shortfalls in the analgesic armamentarium persist. Analgesics based upon novel molecular and genetic mechanisms are being intensively explored to address the unmet needs of patients in pain [42]. The discovery and development of such medicines may require a surprising amount of effort and expense, however, to progress only slightly up the curve shown in Fig. 19.1. To some degree, this slowness to progress may reflect the many late-stage failures among recently developed analgesic compounds due to an unintended negative bias in the current FDA drug approval framework, such as overlooking subgroups of responders [46]. Further, on a global scale, many of the analgesic gaps between ideal and actual practice may be addressed simply by providing access to simple inexpensive agents such as anti-inflammatory drugs or opioids [47]. Nonetheless, even after taking these factors under consideration, it is safe to predict that in the wealthier nations, the search for new analgesics with an improved effect to side-effect profile and improved methods for the delivery of familiar agents will continue for some time to come.