Phase III

Neurology

pain 86#9volume 1,897#14

Pain rank 9 of 76, volume rank 14 of 76 by industry trials. Trials here amend about 1.6x and fail enrollment about 1.4x 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 64 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 $29M at stake per 100 trials. Across the roughly 1,897 industry trials here, the floor is $545M.

If amendments fell by10%$55M30%$164M50%$273M

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 A trial counts as concluded once it has finished, whether completed, terminated or withdrawn.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 sponsors86pain index
Eligibility amendments
64%vs map 40%proxyn = 227sampled
Enrollment failure
19%vs map 13%n = 1,573concluded
Startup lag
63 dvs map 45.5 dn = 1,071with dates
Median duration
26.4 mon = 1,745completed
All sponsors84pain index
Eligibility amendments
56%proxyn = 312sampled
Enrollment failure
19%n = 2,590concluded
Startup lag
74 dn = 2,001with dates
Median duration
28.1 mon = 3,321completed
Why these trials stoppedsponsor decision leads

The most common category here is sponsor decision (74 of 292 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.

Sponsor decision74 (25%)
Efficacy or futility52 (18%)
Safety or tolerability44 (15%)
Low accrual41 (14%)
Not reported34 (12%)
No enrollment recorded (inferred)inferred10 (3%)
Other stated reason8 (3%)
External or regulatory7 (2%)
Superseded by another study6 (2%)
Feasibility or operational failure4 (1%)
Never initiated3 (1%)
Business or funding3 (1%)
Logistics or operations2 (1%)
Technical or device issue1 (0%)
Investigator decision or departure1 (0%)
Change in standard of care1 (0%)
Completed or objective met1 (0%)
n = 292terminated or withdrawn
Evidence12 trials

A sample of terminated or withdrawn trials in this cell.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

TrialSponsorStatusStated reason
NCT06736509Axsome Therapeutics, Inc.terminatedSponsor decision
NCT06715462Eurofarma Laboratorios S.A.withdrawnSponsor decision
NCT06425159Biohaven Therapeutics Ltd.terminatedSponsor decision
NCT06304883Alzheon Inc.terminatedSponsor decision
NCT06111014Alector Inc.terminatedEfficacy or futility
NCT06103734PfizerwithdrawnSponsor decision
NCT05978063Cara Therapeutics, Inc.terminatedSafety or tolerability
NCT05866926Ferrer Internacional S.A.terminatedEfficacy or futility
NCT05814523Marinus PharmaceuticalswithdrawnSponsor decision
NCT05665088BioXcel Therapeutics IncterminatedSafety or tolerability
NCT05643573BayerterminatedEfficacy or futility
NCT05614648Sollis Therapeutics, Inc.terminatedLow accrual

Neurology at other phases