Phase IV

Gastroenterology

pain 50#41volume 191#69

Pain rank 41 of 76, volume rank 69 of 76 by industry trials. Trials here sit close to the map median on both amendments and enrollment failure.

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 39 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 $18M at stake per 100 trials. Across the roughly 191 industry trials here, the floor is $33M.

If amendments fell by10%$3M30%$10M50%$17M

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 A trial counts as concluded once it has finished, whether completed, terminated or withdrawn.

Industry sponsors50pain index
Eligibility amendments
39%vs map 40%proxyn = 44sampled
Enrollment failure
14%vs map 13%n = 172concluded
Startup lag
48 dvs map 45.5 dn = 63with dates
Median duration
15.1 mon = 168completed
All sponsors36pain index
Eligibility amendments
29%proxyn = 87sampled
Enrollment failure
16%n = 749concluded
Startup lag
62 dn = 430with dates
Median duration
19.5 mon = 1,007completed
Why these trials stoppedlow accrual leads

The most common category here is low accrual (14 of 24 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.

Low accrual14 (58%)
Sponsor decision5 (21%)
Feasibility or operational failure2 (8%)
Not reported1 (4%)
Superseded by another study1 (4%)
External or regulatory1 (4%)
n = 24terminated or withdrawn
Evidence12 trials

A sample of terminated or withdrawn trials in this cell. Each links to its ClinicalTrials.gov record.

TrialSponsorStatusStated reason
NCT04315311AbbViewithdrawnSponsor decision
NCT03859869AbbVieterminatedLow accrual
NCT03818672Bausch Health Americas, Inc.terminatedFeasibility or operational failure
NCT03633227Intercept PharmaceuticalsterminatedSponsor decision
NCT03355170Neutec Ar-Ge San ve Tic A.ŞwithdrawnSuperseded by another study
NCT02837783Ironwood Pharmaceuticals, Inc.terminatedLow accrual
NCT02788123Astellas Pharma Europe B.V.terminatedSponsor decision
NCT02401035PfizerterminatedLow accrual
NCT02308111Intercept PharmaceuticalsterminatedLow accrual
NCT02058290Pacira Pharmaceuticals, IncterminatedLow accrual
NCT01920074Forest LaboratorieswithdrawnLow accrual
NCT01887483DaniscoterminatedLow accrual

Gastroenterology at other phases