Thoracic Outlet Syndrome (TOS) Market Size, Share & Industry Analysis, By Drug Class (Anticoagulants, Thrombolytics, Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), Muscle Relaxants, Corticosteroids, and Others), By Type (Neurogenic TOS, Venous TOS, and Arterial TOS) By Route of Administration (Oral, Parenteral, and Others), By Distribution Channel (Hospital Pharmacies, Drug Stores & Retail Pharmacies, and Online Pharmacies), and Regional Forecast, 2025-2032

The global thoracic outlet syndrome (TOS) market size was valued at USD 212.2 million in 2024. The market is projected to grow from USD 227.4 million in 2025 to USD 337.8 million by 2032, exhibiting a CAGR of 5.82% during the forecast period. North America dominated the thoracic outlet syndrome (TOS) market with a market share of 32.99% in 2024.

The TOS market is witnessing a noteworthy growth trajectory during the forecast period. Thoracic outlet syndrome (TOS) is a group of symptoms of compression of neurovascular structures within the thoracic outlet. TOS is linked to repetitive activities, trauma, and anatomical variations.

The rising prevalence of the disease worldwide and the increasing number of awareness programs are shifting the focus toward early diagnosis and conservative treatment. Thus contributing toward global market growth. Moreover, the launches of off-label generic drugs by the key players is to propel the market growth.

• For instance, in June 2025, Sunshine Biopharma Inc. launched a generic version of Gabapentin, a new generic prescription drug in the therapeutic class of anticonvulsants, which is also an off-label treatment for TOS.

Furthermore, the market encompasses several major players with Bayer AG and Pfizer Inc. at the forefront. A robust portfolio with branded and generic offerings is to support the dominance of these companies in the market.

MARKET DYNAMICS

MARKET DRIVERS

Increasing Adoption of Pharmacologic Management before Surgery to Propel Market Growth

One of the most prominent driving factors of the market is the increasing preference for medical management before surgical decompression. Thus, physicians are increasingly prescribing drugs to relieve symptoms and delay or even avoid surgery. Thus, drugs become the first line of treatment for symptom management and thus drive the thoracic outlet syndrome (TOS) market growth.

• For instance, in July 2022, as per the report published by Maastricht University, a study comparing surgery versus continued conservative treatment for neurogenic thoracic outlet syndrome was performed. It was found that 50 patients with neurogenic thoracic outlet syndrome (nTOS) were initially given conservative therapy. Such scenarios are driving the market growth.

MARKET RESTRAINTS

Lack of Approved Drugs and Labelled Indications to Restrict Market Growth

All the drugs used for managing the symptoms of TOS are off-label. There are no FDA or EMA-approved drugs for the treatment of thoracic outlet syndrome, which limits the physician’s confidence during treatment and thus hampers the market growth.

MARKET OPPORTUNITIES

Development of Targeted Neuro-Modulatory and Anti-Spasm Agents to Create Lucrative Growth Opportunities

The development of targeted neuro-modulatory and anti-spasm agents for neurogenic thoracic outlet syndrome (nTOS) presents a significant growth opportunity by addressing current treatment limitations. These innovative therapies aim to precisely relax hypertonic muscles and modulate nerve pain more effectively than conventional NSAIDs, muscle relaxants, or neuropathic agents, which often provide limited relief and cause undesirable side effects, by offering targeted therapies, nTOS management, and driving growth during the global thoracic outlet syndrome (TOS) market forecast period.

• For instance, in March 2024, as per the study published in the Muscle & Nerve Journal, a randomized controlled trial was performed, and it was found that the Botox injections were beneficial in treating nTOS in a majority of patients with a relatively low number of adverse effects.

THORACIC OUTLET SYNDROME (TOS) MARKET TRENDS:

Increasing Awareness Programs to Support Market Growth

Increasing awareness programs are shaping the thoracic outlet syndrome (TOS) treatment market. These programs help educate both healthcare professionals and patients about the condition's symptoms, diagnosis, and available treatment options.

The programs promote early diagnosis and encourage timely intervention, thus leading toward the adoption of drug treatment over surgical intervention, contributing toward the shift in global market trends.

• For instance, in February 2023, Elliot Hospital Vein and Vascular Care Center started a podcast to increase awareness regarding the TOS and treatment associated with it.

MARKET CHALLENGES

Lack of Standardized Diagnostic Criteria to Challenge Market Growth

The lack of standardized diagnostic criteria is leading to misdiagnosis and thus delaying the initiation of appropriate therapy, thus challenging the market growth potential.

• For instance, in October 2023, a study published by the Department of Radiology, University of Gothenburg, Sweden, in the Frontiers journal, found that over 30.0% of neurogenic TOS cases were initially misdiagnosed, delaying appropriate therapy.

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Segmentation Analysis

By Drug Class

Increasing Adoption of NSAIDs to Propel Segmental Growth

On the basis of the segmentation of drug class, the market is classified into anticoagulants, thrombolytics, nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, corticosteroids, and others.

The nonsteroidal anti-inflammatory drugs (NSAIDs) segment held a dominant portion of the thoracic outlet syndrome (TOS) market share in 2024. The dominant share of the segment is due to the large number of cases associated with neurogenic TOS, and NSAIDs are the first-line therapy for pain and inflammation management.

• For instance, as per the data published by The Johns Hopkins University, neurogenic TOS accounts for 90% of total TOS cases. Thus, this leads to increased adoption of NSAIDs for the treatment of other conditions.

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By Type

Majority of Cases Associated with Neurogenic TOS to Bolster Segment’s Growth

In terms of type, the market is categorized into neurogenic TOS, venous TOS, and arterial TOS.

The neurogenic TOS segment held the maximum portion of the market. In 2025, the segment is anticipated to dominate with an 87.6% share. The majority of cases and the rising prevalence of neurogenic TOS are bolstering the segment’s growth in the market.

• For instance, in October 2022, as per the National Library of Medicine, the incidence of neurogenic thoracic outlet syndrome (nTOS) is estimated to be 2-3 per 100,000 per year, with an estimated prevalence of 10 per 100,000 population. Also, this accounts for around 90-95% of total TOS cases.

The venous TOS segment is expected to grow at a CAGR of 4.67% over the forecast period.  

By Route of Administration

Ease of Administration and Wide Availability to Boost Oral Segments' Growth

Based on route of administration, the market is segmented into oral, parenteral, and others.

The oral segment held the dominating position in 2024. By route of administration, the oral segment held the share of 66.3% in 2024. The rising number of cases associated with TOS and majorly neurogenic TOS is leading to an increase in the adoption of oral drugs due to greater convenience and easy availability. Thus making it a preferred choice and contributing toward the segment’s growth.

• For instance, based on the Mayo Clinic’s 2023 treatment guidelines for Thoracic outlet syndrome, NSAIDs, such as ibuprofen or naproxen, are frequently prescribed oral medications that help to decrease inflammation and alleviate pain in patients.

The segment of parenteral is set to flourish with a growth rate of 4.54% across the forecast period.

By Distribution Channels

Increasing Usage of OTC drugs to bolster Drug Store and Retail Pharmacies Segment Growth

Based on distribution channel, the market is segmented into hospital pharmacies, retail pharmacies & drug stores, and online pharmacies.

In 2024, the retail pharmacies & drug stores segment is expected to witness a leading growth trajectory. The segment is set to hold 53.2% share in 2025.  These channels have widespread accessibility and robust availability of the commonly used oral medications such as NSAIDs, muscle relaxants, and neuropathic pain agents for treatment.

• For instance, in addition, hospital pharmacies as a distribution channel are projected to grow at a CAGR of 4.67% during the study period.

Thoracic Outlet Syndrome (TOS) Market Regional Outlook

By region, the market is categorized into Europe, North America, Asia Pacific, Latin America, and the Middle East & Africa.

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North America held the dominant share in 2023, valued at USD 66.0 million, and also took the leading share in 2024 with USD 70.0 million. North America’s dominance in the market is driven by factors such as advanced healthcare facilities and awareness programs. In 2025, the U.S. market is estimated to reach USD 66.7 million.

The U.S. is expected to dominate the North America region's market, owing to the rising prevalence of thoracic outlet syndrome amongst the athletes and the presence of advanced healthcare facilities for quick diagnosis and treatment.

• For instance, in October 2024, as per the data published by NIH, a study was performed to identify the burden of in-hospital admissions and outcomes of thoracic outlet compression syndrome in the U.S. from 2010 to 2021. It was found that in the 37,174 hospitalizations, 7,397 were for venous TOS, 3,346 were for arterial TOS, and 26,430 were for neurogenic TOS.

Other regions, such as Europe and the Asia Pacific, are anticipated to witness a notable growth in the coming years. During the forecast period, the European region is projected to record a growth rate of 6.10%, which is the second highest amongst all the regions, and touch the valuation of USD 59.1 million in 2025. This is primarily driven by the increasing incidence of disease and increasing thoracic outlet syndrome (TOS) awareness programs. Backed by these factors, countries including France are expected to record a valuation of USD 9.4 million, Germany to record USD 12.2 million, and the U.K. to record USD 10.4 million in 2025. After Europe, the market in the Asia Pacific is estimated to reach USD 68.2 million in 2025 and secure the position of the third-largest region in the market. In the region, India and China are both estimated to reach USD 10.9 and USD 16.7 million each in 2025.

Over the forecast period, the Latin America and the Middle East & Africa regions would witness a moderate growth in this market. The Latin America market in 2025 is set to record USD 13.9 million as its valuation. Increasing usage of OTC and generic medication for the TOS treatment to boost the market growth, but at a slower rate. In the Middle East & Africa, GCC is set to attain the value of USD 5.9 million in 2025.

COMPETITIVE LANDSCAPE

Key Industry Players

Expansion of Product Offering and Strong Research and Development Activities to Maintain Their Position

The global TOS market shows a fragmented structure with a small number of large-sized companies actively operating across the globe. These players offer branded as well as generic off-label drugs across the globe.

Bayer AG and Pfizer Inc. are some of the dominating players in the market. The strong range of products with strategic activities to expand their offering to boost their position in the market.

Apart from this, other prominent players in the market include Bristol Myers Squibb and Takeda Pharmaceutical Company Limited, among other major key players in the market. These key players are focusing on offering branded and generic products for the TOS treatment to enhance their market presence.

LIST OF KEY THORACIC OUTLET SYNDROME (TOS) COMPANIES PROFILED

• Bayer AG (Germany)
• Pfizer Inc. (U.S.)
• Bristol-Myers Squibb Company (U.S.)
• Sun Pharmaceutical Industries Ltd. (India)
• Assertio Therapeutics, Inc. (U.S.)
• Daiichi Sankyo Co., Ltd. (Japan)
• Takeda Pharmaceutical Company Limited (U.S.)

KEY INDUSTRY DEVELOPMENTS

• October 2025: Lupin launched generic rivaroxaban for Oral Suspension, 1 mg/mL, in the U.S.
• August 2025: Sandoz launched generic rivaroxaban in Germany, in new strengths of 10 mg, 15 mg, and 20 mg.
• July 2025: Bristol-Myers Squibb Company, in alliance with Pfizer Inc., announced a new direct-to-patient option for purchasing Eliquis (apixaban) with the help of Eliquis 360 Support.
• August 2024: Pfizer Inc. announced that the U.S. Department of Health and Human Services disclosed the “maximum fair price” (MFP) for ELIQUIS (apixaban).
• July 2019: U.S. FDA approved generic version of Pfizer’s Lyrica (pregabalin).

REPORT COVERAGE

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Report Scope & Segmentation