Phase III

Psychiatry

pain 51#38volume 1,410#17

Pain rank 38 of 76, volume rank 17 of 76 by industry trials. Trials here amend about 1.3x and fail enrollment about 0.9x 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 52 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 $23M at stake per 100 trials. Across the roughly 1,410 industry trials here, the floor is $331M.

If amendments fell by10%$33M30%$99M50%$166M

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 A trial counts as concluded once it has finished, whether completed, terminated or withdrawn.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
52%vs map 40%proxyn = 46sampled
Enrollment failure
13%vs map 13%n = 1,267concluded
Startup lag
38 dvs map 45.5 dn = 627with dates
Median duration
20.3 mon = 1,180completed
All sponsors49pain index
Eligibility amendments
50%proxyn = 90sampled
Enrollment failure
13%n = 2,383concluded
Startup lag
60 dn = 1,262with dates
Median duration
27.0 mon = 2,504completed
Why these trials stoppedlow accrual leads

The most common category here is low accrual (36 of 160 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 accrual36 (23%)
Sponsor decision28 (18%)
Safety or tolerability25 (16%)
Efficacy or futility21 (13%)
Not reported13 (8%)
Other stated reason12 (8%)
External or regulatory8 (5%)
No enrollment recorded (inferred)inferred5 (3%)
Business or funding4 (3%)
Technical or device issue2 (1%)
Completed or objective met2 (1%)
Superseded by another study2 (1%)
Never initiated1 (1%)
Logistics or operations1 (1%)
n = 160terminated or withdrawn
Evidence12 trials

A sample of terminated or withdrawn trials in this cell.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

TrialSponsorStatusStated reason
NCT06878833Lyndra Inc.withdrawnSponsor decision
NCT06735079MGGM LLCwithdrawnLow accrual
NCT06635135Janssen Research & Development, LLCterminatedEfficacy or futility
NCT06514742Janssen Research & Development, LLCterminatedEfficacy or futility
NCT06462820Magnus MedicalterminatedBusiness or funding
NCT06215144Neurocentria, Inc.terminatedLow accrual
NCT06088862Rose Research Center, LLCterminatedExternal or regulatory
NCT06011577Levomecor Inc.terminatedSafety or tolerability
NCT05654870Neurocrine BiosciencesterminatedSafety or tolerability
NCT05643170Karuna Therapeutics, Inc., a Bristol Myers Squibb companyterminatedSponsor decision
NCT05555615ACADIA Pharmaceuticals Inc.terminatedSafety or tolerability
NCT05518149Janssen Research & Development, LLCterminatedLogistics or operations

Psychiatry at other phases