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Neuromuscular Blocking Drugs Market Size & Share, by Route of Administration (Intravenous, Intramuscular); End user; Non-Depolarizing Type; Distribution Channel; Drug Class - SWOT Analysis, Competitive Strategic Insights, Regional Trends 2026-2035

  • Report ID: 2564
  • Published Date: Sep 30, 2025
  • Report Format: PDF, PPT

Neuromuscular Blocking Drugs Market Outlook:

Neuromuscular Blocking Drugs Market size was valued at USD 4.3 billion in 2025 and is projected to reach USD 7.5 billion by the end of 2035, rising at a CAGR of 5.8% during the forecast period, i.e., 2026-2035. In 2026, the industry size of neuromuscular blocking drugs is assessed USD 4.5 billion.

The global neuromuscular blocking drugs market is driven by the critical care requirements and the rising patient pool. As per the NLM article in May 2024, nearly 234.2 million surgical procedures were performed globally, involving neuromuscular blocking drugs for intubation or muscular relaxation. Further, the market is driven by the rise in the aging population and prevalence of chronic disease. In parts of Latin America and the Asia Pacific, the public health systems have maximized access to anesthesia-aided procedures. As per the WHO report, the developing countries are broadening their healthcare capacities. This expansion in the patient pool necessitates support for long-term stability and volume growth for the neuromuscular blocking drugs (NMBD) market. 

On the supply chain side, the production of neuromuscular blocking drugs is highly dependent on Active Pharmaceutical Ingredients (API). The API are mainly manufactured in China, India, and parts of Europe, with final formulation made in the U.S. The Muscular Dystrophy Association report in June 2024 states that NIH has allocated USD 47.08 billion for therapies and drugs related to neuromuscular research. Delay in the raw materials from China has led to the rise in the value chain during the period 2021 to 2022. Further, government-led investment in anesthesia safety mechanisms and research has also risen. 

Neuromuscular Blocking Drugs Market Size
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Growth Drivers

  • Product innovation by leading manufacturers: Merck & Co. increased its Bridion (Sugammadex) production facilities in partnership with the U.S. Department of Health and Human Services in 2024, surging the domestic production. At the same time, Fresenius Kabi entered multi-year distribution agreements with European public hospitals, allowing greater NMBD availability. These initiatives enhanced logistics resilience, public confidence in reversal agents, and helped each company achieve a growth in market share in the worldwide NMBD business. Further, these growths also made both companies prominent suppliers during regional NMBD shortages in Q4 2024. Additionally, increased production capacity enabled quicker response times in emergency surgical care among high-volume hospitals.
  • Finished drugs and trade dynamics: As per the OEC data, the global trade of pharmaceutical products, including neuromuscular blocking drugs, reached USD 853 billion in 2023. Often, the finished drugs were reassembled in Europe and the U.S. before distribution. However, the export restriction challenges and geopolitical tensions in Asia have put pressure on improved lead times. Investing in nearshore assembly operations and diversifying API procurement are increasingly important tactics being used by multinational pharmaceutical companies. This transformation is surging companies to innovate products and establish partnerships with regional players to stabilize the supply chain and avoid future disruptions.
  • Medicare & Medicaid trends in surgical demand: One in 25 people around the globe have undergone surgical procedures, as per the NLM study in May 2024. With expanded access to elective surgery and minimally invasive procedures, NMBD usage is surging in hospitals and outpatient facilities. The Centers for Medicare & Medicaid Services (CMS) predicts that increasing expenditures on perioperative medications suggest sustained NMBD demand. This reflects the increasing importance of NMBDs in improving surgical efficiency, patient safety, and postoperative recovery outcomes among U.S. healthcare institutions.

Effects of Medical Conditions on NMBAs

Disease

Response to nondepolarizing NMBA

Response to depolarizing NMBA

Amyotrophic lateral sclerosis

Sensitive

↑ risk of hyperkalemia

Muscular dystrophy

Normal

↑ risk of hyperkalemia, rhabdomyolysis

Burn injury

Resistance

↑ risk of hyperkalemia (after the first 24 hrs.)

Elderly age

Prolonged duration, smaller dose required

Normal

Guillain-Barré

Sensitive

↑ risk of hyperkalemia

Hypothermia

Prolonged duration

Normal

Lambert-Eaton syndrome

Sensitive

Sensitive

Multiple sclerosis

Sensitive or Resistant*

↑ risk of hyperkalemia

Myasthenia gravis

Sensitive

Resistance

Spinal cord injury

Normal

↑ risk of hyperkalemia (after the first 24 hrs.)

Stroke

Resistance on affected side

↑ risk of hyperkalemia

Source: Open Anesthesia in May 2023

Challenges

  • Deficiency in regional manufacturing of API: South Africa and Brazil are the key sources to rely on the import of API, producing supply chain vulnerabilities. During the period 2021 to 2022 shipping delays, the import of API dropped and is reshaping the NMBD formulation availability in public hospitals. As per the WHO Essential Medicines Supply Chain report, the gaps in the supply chain impact the sustainable drug access mainly during trade disputes and pandemics. To overcome these risks in the future, both countries have started pubic private partnerships aimed at enhancing local API manufacturing capabilities. To protect against worldwide supply disruptions, regional health ministries are also building up strategic stocks of vital anesthetics, such as NMBDs.
  • Government-regulated cost ceilings: Most of the countries have stringent price ceilings for generic drugs. In Germany and France, reference pricing restricts reimbursement amounts for NMBDs, resulting in low profit margins. In 2023, Fresenius Kabi evaded this by securing volume discounts from public hospital procurements, enhancing availability by 10%. Yet, NMBD prices in India are governed under the Drug Price Control Order (DPCO), dissuading foreign market entry because of low ROI.

Neuromuscular Blocking Drugs Market Size and Forecast:

Report Attribute Details

Base Year

2025

Forecast Year

2026-2035

CAGR

5.8%

Base Year Market Size (2025)

USD 4.3 billion

Forecast Year Market Size (2035)

USD 7.5 billion

Regional Scope

  • North America (U.S., and Canada)
  • Asia Pacific (Japan, China, India, Indonesia, Malaysia, Australia, South Korea, Rest of Asia Pacific)
  • Europe (UK, Germany, France, Italy, Spain, Russia, NORDIC, Rest of Europe)
  • Latin America (Mexico, Argentina, Brazil, Rest of Latin America)
  • Middle East and Africa (Israel, GCC North Africa, South Africa, Rest of the Middle East and Africa)
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Neuromuscular Blocking Drugs Market Segmentation:

Route of Administration Segment Analysis

Intravenous dominates the segment and is projected to hold the revenue share of 82.9% by 2035. The segment is led by its rapid onset of action, accuracy in dose control, and applicability in both elective and emergency procedures. Intravenous administration is a regular process in the operating rooms and critical care units, where a neuromuscular blockade is required for intubation and ventilation management. As per the CDC's hospital utilization statistics report, mostly NMBDs used for inpatient surgery in the U.S. were delivered intravenously. Further, intravenous formulations also allow for easy titration, improving procedural safety and aligning with the latest surgical standards in high-throughput hospital systems.

End user Segment Analysis

Hospitals dominate the segment and are poised to hold the market share of 74.9% by 2035. Hospitals are the leading end user segment because of their heavy infrastructure demands for surgeries and critical care ventilation, which are the main use cases for NMBDs. As per the ISAPS report in June 2025, 52.6% of surgical procedures were performed in hospitals worldwide, highlighting the demand on NMBDs. Hospital network growth worldwide, particularly within the APAC and MENA regions, accelerates institutional procurement through bulk government contracts. Subsidized reimbursement schemes and centralized buying practices that support large-scale hospital procurement of NMBDs are driving this institutional demand.

Non-Depolarizing Type Segment Analysis

The aminosteroids including rocuronium and vecuronium in the non-depolarizing type segment lead the segment by 2035. The market is driven by the wide usage of routine surgical procedures and compatibility with Sugammadex, which provides a quick and safe neuromuscular blockade reversal. As per the NLM study in July 2021, 4.3 million in patients who are adults are encountered involving rocuronium or vecuronium. In industrialized markets, aminosteroids are now the recommended option for anesthetic regimens due to the growing need for intermediate-acting drugs with predictable pharmacokinetics. As per the AHRQ and FDA report, aminosteriods have a high safety profile used for quick patient recovery in the U.S., leading to a reduction in hospitalization stay and lower procedural complications.

Our in-depth analysis of the global neuromuscular blocking drugs market includes the following segments:

Segment

Subsegments

Drug Class
  • Depolarizing
  • Intravenous (IV)
  • Intramuscular (IM)
  • Non-Depolarizing
  • Intravenous (IV)
  • Intramuscular (IM)

Non-Depolarizing Type
  • Aminosteroids
  • Benzylisoquinolinium Compounds

Route of Administration
  • Intravenous (IV)
  • Hospital Pharmacies
  • Intramuscular (IM)
  • Hospital Pharmacies

Distribution Channel
  • Hospital Pharmacies
  • Retail Pharmacies
  • Online Pharmacies

End user
  • Hospitals
  • Ambulatory Surgical Centers (ASCs)
  • Specialty Clinics
Vishnu Nair
Vishnu Nair
Head - Global Business Development

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Neuromuscular Blocking Drugs Market - Regional Analysis

North America Market Insights

North America neuromuscular blocking drugs market is expected to maintain the highest regional share by 2035, with about 36.9% of total revenue at a CAGR of 6.1% due to large volumes of surgical procedures, strong healthcare infrastructure, and government-supported reimbursements. Increasing demand for general anesthetics in inpatient and outpatient surgery, as well as ICU modernization and national readiness programs, continues to promote adoption. Supported by top associations like AMA, PhRMA, and Innovative Medicines Canada, the region is experiencing faster regulatory clearances, generics growth, and public-private R&D partnerships, making North America a market and innovation center for neuromuscular blocking drugs up to 2035.

The neuromuscular blocking drugs market in U.S. is driven by the inpatient surgery procedures, 12.0 to 21.4 operations per 100,000 people having undergone surgeries for various issues, based on the NLM report in April 2024. A primary driver dominating the market is the favourable reimbursement for sugammadex, which reached a significant portion of Medicare Part B spending on reversal agents. Federal support is substantial, with the NIH allocating significant funding for research into safer anesthetic agents. Continued investment from federal agencies and a strong surgical volume base ensure steady market growth.

The neuromuscular blocking drugs market in Canada is driven by the universal and publicly funded healthcare system. The key trend is the proactive assessment and new drugs funding by the Canadian Agency for Drugs and Technologies in Health which has recommended the newer NMBDs and reversal agents to enhance patient outcome. The Government of Canada report in 2023 has depicted that the prescription drugs is growing at a CAGR of 7.1% from 2018 to 2023. This growth is further supported by the adoption of advanced neuromuscular blocking drugs within Canada’s hospital and surgical settings.

Prescription Drug Utilization Trends

Year

Drug costs

Dispensing costs

Claims

Claimants

2013

1.00

1.00

1.00

1.00

2014

1.06

1.04

1.04

1.03

2015

1.12

1.06

1.07

1.06

2016

1.17

1.11

1.11

1.09

2017

1.25

1.16

1.15

1.13

2018

1.30

1.21

1.19

1.13

2019

1.42

1.29

1.25

1.22

2020

1.50

1.39

1.30

1.13

2021

1.61

1.39

1.27

1.16

2022

1.68

1.45

1.30

1.20

2023

1.92

1.51

1.39

1.30†

Source: Government of Canada 2023

Asia Pacific Market Insights

The APAC is the fastest-growing region in the neuromuscular blocking drugs market and is anticipated to hold a considerable market share by 2035. The market is supported by rising ICU admissions, increasing surgical volumes, and national investment in perioperative and emergency care. India, Japan, and China are dominating countries in the market, with Japan focusing on advanced anesthetic drugs. This growth is further being fueled by trends including aging populations, a rise in the prevalence of trauma and chronic illnesses, and easier access to anesthetic treatments in remote hospitals. The region is strengthened by high R&D investments and fast drug review by AMED, CDSCO, and NMPA.

China is the dominating shareholder in the market in Asia Pacific region. The NLM study in February 2025 has provided evidence that the annual number of surgeries in china exceeded 1.25 million, highlighting the immense requirement of neuromuscular blocking drug, sustaining robust market growth. Further, the Healthy China 2030 initiative has prioritized access to essential perioperative drugs in public hospitals across Tier 2 and Tier 3 cities. This strategy lines up with the availability of critical care drugs and expanded health care reform goals across rural areas.

The neuromuscular blocking drugs market in India is experiencing rapid growth due to the rising surgical procedures performed, increasing use of anesthesia in critical care, and expanding healthcare infrastructure. With the rising elderly population and incidence of chronic diseases that require surgeries are the crucial drivers of the market. Further, the government initiatives are strengthening the hospitals and raising the private sector investment for advanced facilities in the healthcare sector for market expansion. Additionally, greater awareness of safe anesthesia practices is enhancing NMBD adoption.

Europe Market Insights

The neuromuscular blocking drugs market in Europe is significantly expanding and is poised to hold the largest market share by 2035. The market is fueled by the rising demand for intensive care interventions and surgical procedures. The region witnesses a rise in cardiovascular and chronic respiratory conditions, raising the demand for NMBD mainly in critical care units. Further, the technological advancements in enhanced monitoring protocols and short-acting NMBDs are improving patient care. Countries like the UK, Germany, and France are driving the market with the rise in the aging population and procedural volume in public hospitals.

Germany is expected to dominate the neuromuscular blocking drugs market in Europe and is estimated to capture the largest share by 2035. The market is propelled as a result of strong national procurement policies, centralized delivery of healthcare, and technological advancement. The Federal Ministry of Health has initiated a large-scale investment in the procurement of surgical and ICU medicines via national tenders, which have improved efficiency and access. As per the Eurostat report in November 2024, the healthcare expenditure reached €488,677 in 2022, including anesthesiology. Additionally, collaborations with local pharma producers (such as Fresenius Kabi) have promoted production locally and reduced drug shortages.

France Neuromuscular Blocking Drugs (NMBDs) market is growing steadily due to a rise in surgical intervention and increasing intensive care units. The strong public healthcare system and high per capita healthcare spending in France favor the use of both conventional and newer NMBDs, including reversal agents. Rising demand for patient safety, fast recovery, and newer forms of anesthesia further fuels market growth. On the other hand, public policy and hospital purchase programs increases the availability, making France a major player in the European NMBD market.

Healthcare Expenditure in Europe

Country

2019

2020

2021

2022

Overall Change 2014-22 (%)

Germany

407,025

431,941

466,713

488,677

51.4

France

270,562

279,815

307,568

313,574

26.6

Spain

113,776

120,093

126,001

131,114

39.7

Source: Eurostat, November 2024

Neuromuscular Blocking Drugs Market Share
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Key Neuromuscular Blocking Drugs Market Players:

    The neuromuscular blocking drugs market is dominated by Merck, Fresenius Kabi, and Pfizer based on their worldwide hospital networks and diversified NMBD portfolios.  Players such as Hikma, Viatris, and Bharat Serums compete with others based on their portfolio via price-effective injectables. Strategic activities involve hospital group alliances, contract manufacturing, and filing for newer NMBD formulations with regulatory bodies. Japan, India, and South Korea players are capitalizing on local demand and cost competitiveness.  Continuous and sustained R&D in short-acting and safer NMBDs keeps innovation for long-term competitiveness.

    Below is the list of some prominent players operating in the market:

    Company Name

    Country of Origin

    Est. Market Share (2025)

    Industry Focus

    Merck & Co., Inc.

    U.S.

    9.9%

    Focuses on anesthetic and ICU drugs including Rocuronium and Pancuronium formulations; strong distribution in hospitals globally

    Fresenius Kabi AG

    Germany

    9.7%

    Leading NMBD producer in Europe; specializes in injectable Rocuronium and Cisatracurium with large-scale hospital supply contracts

    Pfizer Inc.

    U.S.

    9.2%

    Offers Vecuronium and Atracurium under its hospital portfolio; heavily used in ICUs and operating theatres worldwide

    Hikma Pharmaceuticals

    UK

    6.9%

    Supplies generic NMBDs such as Atracurium and Vecuronium; focused on cost-effective injectable formulations

    Mylan/Viatris Inc.

    U.S.

    6.5%

    Provides generic NMBDs for hospitals and outpatient surgical centers; strong in Latin America and Europe

    Aspen Pharmacare

    South Africa

    xx%

    Key player in generic NMBD injectables; operates large facilities in Asia-Pacific; distributed via EU procurement networks

    Sandoz (a Novartis division)

    Switzerland

    xx%

    Generic NMBD manufacturer with EU-wide and North American supply chains; specializes in Cisatracurium

    Bharat Serums and Vaccines Ltd.

    India

    xx%

    Manufactures Rocuronium and Atracurium; strong focus on Southeast Asian hospital markets

    Nichi-Iko Pharmaceutical Co., Ltd.

    Japan

    xx%

    Japanese NMBD provider with localized R&D and hospital-centered distribution; focuses on Pancuronium

    Yungjin Pharm Co., Ltd.

    South Korea

    xx%

    Manufactures and exports NMBDs such as Vecuronium; strong regulatory approvals across Asia-Pacific

    Troikaa Pharmaceuticals Ltd.

    India

    xx%

    Focuses on injectables, including NMBDs; expanding its footprint in Africa and Southeast Asia

    Gland Pharma Ltd.

    India

    xx%

    Contract manufacturer of generic Rocuronium and Atracurium for major global pharma brands

    Piramal Pharma Solutions

    India

    xx%

    Custom manufacturer and CDMO partner in neuromuscular agents for North America and EU

    Hameln Pharma GmbH

    Germany

    xx%

    Specializes in sterile hospital injectables including NMBDs; supplies to over 50 countries

    B. Braun Melsungen AG

    Germany

    xx%

    Offers Rocuronium and Vecuronium for ICU and surgical settings; strong in Europe and Middle East

    Orion Corporation

    Finland

    xx%

    Provides hospital-use neuromuscular blockers; involved in clinical trials and EU hospital tenders

    TTY Biopharm Company Limited

    Taiwan

    xx%

    Regional NMBD supplier with growing Southeast Asia presence

    Aurobindo Pharma

    India

    xx%

    Generic supplier of hospital NMBDs; growing U.S. and EU market share

    Malaysian Genomics Resource Centre

    Malaysia

    xx%

    Developing NMBDs for research and public hospital usage in ASEAN region

    CSL Limited

    Australia

    xx%

    Australian leader in hospital pharmaceuticals with R&D in short-acting NMBDs

    Below are the areas covered for each company in the market:

    • Company Overview
    • Business Strategy
    • Key Product Offerings
    • Financial Performance
    • Key Performance Indicators
    • Risk Analysis
    • Recent Development
    • Regional Presence
    • SWOT Analysis
    • In the News

Recent Developments

  • In April 2025, Johnson & Johnson received the FDA approval for IMAAVYTM, which is a new FcRn blocker providing long-lasting disease control in the broadest population of people living with generalized myasthenia gravis (gMG).
  • In March 2025, Hikma Pharmaceuticals launched Cisatracurium Besylate Injection, USP in 200mg/20mL and 20mg/10mL doses in the U.S., which is used to provide skeletal muscle relaxation in adults during surgical procedures or during mechanical ventilation in the ICU.
  • Report ID: 2564
  • Published Date: Sep 30, 2025
  • Report Format: PDF, PPT
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Frequently Asked Questions (FAQ)

In the year 2025, the industry size of neuromuscular blocking drugs is evaluated at USD 4.3 billion.

The neuromuscular blocking drugs market size was valued at USD 4.3 billion in 2025 and is projected to reach USD 7.5 billion by the end of 2035, rising at a CAGR of 5.8% during the forecast period, i.e., 2026-2035.

North America neuromuscular blocking drugs market is expected to maintain the highest regional share by 2035, with about 36.9% of total revenue at a CAGR of 6.1% due to large volumes of surgical procedures, strong healthcare infrastructure, and government-supported reimbursements.

The major players in the market are Merck & Co., Inc., Fresenius Kabi AG, Pfizer Inc., Hikma Pharmaceuticals, Mylan/Viatris Inc., Aspen Pharmacare, Sandoz (a Novartis division), Bharat Serums and Vaccines Ltd., Nichi-Iko Pharmaceutical Co., Ltd., Yungjin Pharm Co., Ltd., Troikaa Pharmaceuticals Ltd., Gland Pharma Ltd., Piramal Pharma Solutions, Hameln Pharma GmbH, B. Braun Melsungen AG, Orion Corporation, TTY Biopharm Company Limited, Aurobindo Pharma, Malaysian Genomics Resource Centre, CSL Limited.

Neuromuscular Blocking Drugs Market Report Scope

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