Phase II

Infectious Disease

pain 51#38volume 3,311#5

Pain rank 38 of 76, volume rank 5 of 76 by industry trials. Trials here amend about 0.9x and fail enrollment about 1.3x 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 36 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 $16M at stake per 100 trials. Across the roughly 3,311 industry trials here, the floor is $530M.

If amendments fell by10%$53M30%$159M50%$265M

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 A trial counts as concluded once it has finished, whether completed, terminated or withdrawn.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 sponsors51pain index
Eligibility amendments
36%vs map 40%proxyn = 45sampled
Enrollment failure
17%vs map 13%n = 2,794concluded
Startup lag
45 dvs map 45.5 dn = 1,926with dates
Median duration
13.4 mon = 3,095completed
All sponsors62pain index
Eligibility amendments
42%proxyn = 84sampled
Enrollment failure
18%n = 5,352concluded
Startup lag
62 dn = 3,948with dates
Median duration
15.7 mon = 6,238completed
Why these trials stoppedlow accrual leads

The most common category here is low accrual (120 of 487 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 accrual120 (25%)
Sponsor decision101 (21%)
Safety or tolerability53 (11%)
Efficacy or futility50 (10%)
Not reported43 (9%)
Logistics or operations20 (4%)
Superseded by another study18 (4%)
No enrollment recorded (inferred)inferred17 (3%)
Business or funding14 (3%)
Change in standard of care11 (2%)
External or regulatory10 (2%)
Other stated reason10 (2%)
Never initiated9 (2%)
Completed or objective met6 (1%)
Technical or device issue3 (1%)
Feasibility or operational failure1 (0%)
Investigator decision or departure1 (0%)
n = 487terminated or withdrawn
Evidence12 trials

A sample of terminated or withdrawn trials in this cell.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

TrialSponsorStatusStated reason
NCT07492888ImmunityBio, Inc.withdrawnSuperseded by another study
NCT06990776Chia Tai Tianqing Pharmaceutical Group Co., Ltd.withdrawnSafety or tolerability
NCT06939816Enyo PharmaterminatedSponsor decision
NCT06784973Gilead SciencesterminatedSafety or tolerability
NCT06585150Gilead SciencesterminatedSafety or tolerability
NCT06536465Recursion Pharmaceuticals Inc.terminatedSafety or tolerability
NCT06489860DHA Coffee Co., LtdwithdrawnExternal or regulatory
NCT06375772G.ST Antivirals GmbHterminatedSuperseded by another study
NCT06245291Arbutus Biopharma CorporationwithdrawnSponsor decision
NCT06202521Senhwa Biosciences, Inc.terminatedLow accrual
NCT06142461PharmaJet, Inc.withdrawnChange in standard of care
NCT06133010ModernaTX, Inc.withdrawnSponsor decision

Infectious Disease at other phases