Phase IV
Endocrine & Metabolic
Pain rank 45 of 76, volume rank 38 of 76 by industry trials. Trials here amend about 1.0x and fail enrollment about 0.8x the map median.
What this is worth
The amendment proxy, priced. Order of magnitude, anchor cited, assumptions on the table.
Per 100 industry trials in this cell, about 42 rewrite their eligibility criteria at least once. At the industry average of $450k direct cost per amendment, with the 6+ weeks of delay each not even counted, that is at least $19M at stake per 100 trials. Across the roughly 646 industry trials here, the floor is $123M.
Assumes $450k direct cost per amendment (industry average; Phase II median runs lower, Phase III higher, and delay cost is excluded), applied to the proxy rate. The proxy counts only trials with at least one eligibility change, so this understates the true exposure. How this is derived.
The signals
Industry sponsors first, since that is the commercial buyer, each figure shown against the map median. All-sponsor figures follow. A trial counts as concluded once it has finished, whether completed, terminated or withdrawn.
- Eligibility amendments
- 42%vs map 40%proxyn = 45sampled
- Enrollment failure
- 11%vs map 13%n = 584concluded
- Startup lag
- 44 dvs map 45.5 dn = 268with dates
- Median duration
- 17.0 mon = 593completed
- Eligibility amendments
- 30%proxyn = 90sampled
- Enrollment failure
- 14%n = 1,964concluded
- Startup lag
- 63 dn = 1,149with dates
- Median duration
- 21.0 mon = 2,533completed
Why these trials stoppedlow accrual leads
The most common category here is low accrual (20 of 62 stopped). A keyword pass runs first; free text it could not place was sorted once by a frozen AI classification into these same categories, auditable rather than a live model. "No enrollment recorded (inferred)" is not a stated reason: it is read from a zero enrollment count, meaning the trial never enrolled anyone. "Not reported" means the sponsor left the field blank, shown rather than hidden.
Evidence12 trials
A sample of terminated or withdrawn trials in this cell. Each links to its ClinicalTrials.gov record.
| Trial | Sponsor | Status | Stated reason |
|---|---|---|---|
| NCT05552859 | Sanofi | terminated | Low accrual |
| NCT05228184 | IBSA Institut Biochimique SA | terminated | Low accrual |
| NCT04997161 | AstraZeneca | terminated | Efficacy or futility |
| NCT04864977 | Eli Lilly and Company | withdrawn | Sponsor decision |
| NCT03779906 | Bracco Diagnostics, Inc | terminated | External or regulatory |
| NCT03646916 | Ascension Health | withdrawn | Low accrual |
| NCT03631771 | GE Healthcare | withdrawn | Change in standard of care |
| NCT03344341 | AstraZeneca | terminated | Sponsor decision |
| NCT03338296 | Eisai Inc. | terminated | External or regulatory |
| NCT03260868 | Sanofi | terminated | Low accrual |
| NCT03226899 | Ironwood Pharmaceuticals, Inc. | terminated | Safety or tolerability |
| NCT03152084 | AstraZeneca | terminated | Low accrual |