Phase IV

Hematology

pain 92#4volume 206#67

Pain rank 4 of 76, volume rank 67 of 76 by industry trials. Trials here amend about 1.4x and fail enrollment about 1.8x 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 57 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 $26M at stake per 100 trials. Across the roughly 206 industry trials here, the floor is $53M.

If amendments fell by10%$5M30%$16M50%$26M

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 A trial counts as concluded once it has finished, whether completed, terminated or withdrawn.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 sponsors92pain index
Eligibility amendments
57%vs map 40%proxyn = 200sampled
Enrollment failure
24%vs map 13%n = 182concluded
Startup lag
92 dvs map 45.5 dn = 98with dates
Median duration
24.1 mon = 182completed
All sponsors82pain index
Eligibility amendments
48%proxyn = 290sampled
Enrollment failure
22%n = 611concluded
Startup lag
70 dn = 465with dates
Median duration
23.0 mon = 871completed
Why these trials stoppedlow accrual leads

The most common category here is low accrual (18 of 43 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 accrual18 (42%)
Other stated reason5 (12%)
No enrollment recorded (inferred)inferred4 (9%)
Safety or tolerability4 (9%)
External or regulatory4 (9%)
Not reported4 (9%)
Sponsor decision2 (5%)
Completed or objective met1 (2%)
Business or funding1 (2%)
n = 43terminated or withdrawn
Evidence12 trials

A sample of terminated or withdrawn trials in this cell.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

TrialSponsorStatusStated reason
NCT05856266Swedish Orphan BiovitrumterminatedSponsor decision
NCT05228821PfizerwithdrawnSafety or tolerability
NCT04443608Comprehensive Research AssociatesterminatedLow accrual
NCT03866798OctapharmaterminatedExternal or regulatory
NCT03361137Genentech, Inc.terminatedLow accrual
NCT02624141Hoffmann-La RocheterminatedLow accrual
NCT02608060Hoffmann-La RocheterminatedLow accrual
NCT02512601Bama GeVe, S.L.U.terminatedLow accrual
NCT02472665Grifols Therapeutics LLCwithdrawnLow accrual
NCT02443545ApoPharmaterminatedCompleted or objective met
NCT02041299ApoPharmaterminatedLow accrual
NCT01866709ZS Pharma, Inc.terminatedSafety or tolerability

Hematology at other phases