Phase I

Pain & Anesthesiology

pain 4#75volume 287#63

Pain rank 75 of 76, volume rank 63 of 76 by industry trials. Trials here amend about 0.2x and fail enrollment about 0.5x 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 7 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 $3M at stake per 100 trials. Across the roughly 287 industry trials here, the floor is $9M.

If amendments fell by10%$900k30%$3M50%$5M

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 A trial counts as concluded once it has finished, whether completed, terminated or withdrawn.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 sponsors4pain index
Eligibility amendments
7%vs map 40%proxyn = 43sampled
Enrollment failure
7%vs map 13%n = 256concluded
Startup lag
23 dvs map 45.5 dn = 129with dates
Median duration
4.0 mon = 274completed
All sponsors8pain index
Eligibility amendments
11%proxyn = 87sampled
Enrollment failure
11%n = 540concluded
Startup lag
46 dn = 350with dates
Median duration
8.6 mon = 696completed
Why these trials stoppedsponsor decision leads

The most common category here is sponsor decision (8 of 18 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 decision8 (44%)
Efficacy or futility2 (11%)
Low accrual2 (11%)
Not reported2 (11%)
Safety or tolerability2 (11%)
No enrollment recorded (inferred)inferred2 (11%)
n = 18terminated or withdrawn
Evidence12 trials

A sample of terminated or withdrawn trials in this cell.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

TrialSponsorStatusStated reason
NCT06243835Lohocla Research CorporationterminatedSafety or tolerability
NCT04475198SiteOne Therapeutics, Inc.terminatedSponsor decision
NCT04114656GlaxoSmithKlineterminatedEfficacy or futility
NCT03880487Kalyra Pharmaceuticals, Inc.terminatedSponsor decision
NCT03802227Nektar TherapeuticsterminatedSponsor decision
NCT03751969Sichuan Haisco Pharmaceutical Group Co., LtdwithdrawnSponsor decision
NCT03428984Pacira Pharmaceuticals, IncterminatedLow accrual
NCT03418805Overseas Pharmaceuticals, Ltd.terminatedSponsor decision
NCT03399435Grünenthal GmbHterminatedSafety or tolerability
NCT03137030Grünenthal GmbHwithdrawnSponsor decision
NCT03137017Grünenthal GmbHwithdrawnSponsor decision
NCT02679339Centrexion TherapeuticsterminatedLow accrual

Pain & Anesthesiology at other phases