Phase III

Pain & Anesthesiology

pain 39#50volume 455#51

Pain rank 50 of 76, volume rank 51 of 76 by industry trials. Trials here amend about 1.0x and fail enrollment about 0.6x 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 41 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 $18M at stake per 100 trials. Across the roughly 455 industry trials here, the floor is $85M.

If amendments fell by10%$8M30%$25M50%$42M

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 A trial counts as concluded once it has finished, whether completed, terminated or withdrawn.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 sponsors39pain index
Eligibility amendments
41%vs map 40%proxyn = 46sampled
Enrollment failure
9%vs map 13%n = 422concluded
Startup lag
44 dvs map 45.5 dn = 202with dates
Median duration
9.0 mon = 401completed
All sponsors31pain index
Eligibility amendments
30%proxyn = 91sampled
Enrollment failure
13%n = 1,003concluded
Startup lag
61 dn = 629with dates
Median duration
13.0 mon = 1,217completed
Why these trials stoppedlow accrual leads

The most common category here is low accrual (12 of 36 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 accrual12 (33%)
Sponsor decision10 (28%)
Not reported4 (11%)
Safety or tolerability2 (6%)
No enrollment recorded (inferred)inferred2 (6%)
Efficacy or futility2 (6%)
Superseded by another study1 (3%)
Change in standard of care1 (3%)
External or regulatory1 (3%)
Other stated reason1 (3%)
n = 36terminated or withdrawn
Evidence12 trials

A sample of terminated or withdrawn trials in this cell.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

TrialSponsorStatusStated reason
NCT05845008Johnson & Johnson Consumer Inc. (J&JCI)withdrawnSponsor decision
NCT03722238PfizerterminatedSafety or tolerability
NCT03560986Grünenthal GmbHterminatedSponsor decision
NCT03530345Grünenthal GmbHterminatedSponsor decision
NCT03127592Apsen Farmaceutica S.A.terminatedLow accrual
NCT03005899SymBio PharmaceuticalsterminatedSponsor decision
NCT02722603Pharmaceutical Research Management srlterminatedLow accrual
NCT02687451Endo USA Inc., a Keenova Therapeutics CompanyterminatedExternal or regulatory
NCT02523859Paion UK Ltd.terminatedLow accrual
NCT02321319MallinckrodtterminatedSponsor decision
NCT02310581INSYS Therapeutics IncterminatedSponsor decision
NCT02254525Biomendi S.A.U.terminatedLow accrual

Pain & Anesthesiology at other phases