Phase IV

Nephrology & Urology

pain 34#55volume 337#59

Pain rank 55 of 76, volume rank 59 of 76 by industry trials. Trials here amend about 0.9x and fail enrollment about 0.7x 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 37 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 $17M at stake per 100 trials. Across the roughly 337 industry trials here, the floor is $56M.

If amendments fell by10%$6M30%$17M50%$28M

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 A trial counts as concluded once it has finished, whether completed, terminated or withdrawn.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 sponsors34pain index
Eligibility amendments
37%vs map 40%proxyn = 49sampled
Enrollment failure
9%vs map 13%n = 311concluded
Startup lag
44 dvs map 45.5 dn = 91with dates
Median duration
20.1 mon = 276completed
All sponsors52pain index
Eligibility amendments
34%proxyn = 94sampled
Enrollment failure
16%n = 1,000concluded
Startup lag
63 dn = 536with dates
Median duration
23.8 mon = 1,288completed
Why these trials stoppedlow accrual leads

The most common category here is low accrual (13 of 29 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 accrual13 (45%)
Not reported5 (17%)
Other stated reason4 (14%)
Safety or tolerability3 (10%)
Logistics or operations1 (3%)
Never initiated1 (3%)
Feasibility or operational failure1 (3%)
No enrollment recorded (inferred)inferred1 (3%)
n = 29terminated or withdrawn
Evidence12 trials

A sample of terminated or withdrawn trials in this cell.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

TrialSponsorStatusStated reason
NCT03119662GE HealthcareterminatedLow accrual
NCT02963103Astellas Pharma Korea, Inc.terminatedLow accrual
NCT02372695Effice Servicios Para la Investigacion S.L.terminatedFeasibility or operational failure
NCT02268201Astellas Pharma China, Inc.terminatedLow accrual
NCT01673490GlaxoSmithKlineterminatedSafety or tolerability
NCT01302938Pfizer's Upjohn has merged with Mylan to form Viatris Inc.terminatedLow accrual
NCT01269684Novartis PharmaceuticalswithdrawnNever initiated
NCT01018225Cognitive Research CorporationwithdrawnLow accrual
NCT00991510Teva Branded Pharmaceutical Products R&D, Inc.terminatedLow accrual
NCT00956293Novartis PharmaceuticalsterminatedLow accrual
NCT00936247B. Braun Melsungen AGterminatedLow accrual
NCT00871975Laborie Medical Technologies Inc.terminatedLow accrual

Nephrology & Urology at other phases