Phase IV

Women's & Reproductive Health

pain 84#10volume 109#76

Pain rank 10 of 76, volume rank 76 of 76 by industry trials. Trials here amend about 1.2x and fail enrollment about 1.6x 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 49 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 $22M at stake per 100 trials. Across the roughly 109 industry trials here, the floor is $24M.

If amendments fell by10%$2M30%$7M50%$12M

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 A trial counts as concluded once it has finished, whether completed, terminated or withdrawn.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 sponsors84pain index
Eligibility amendments
49%vs map 40%proxyn = 49sampled
Enrollment failure
21%vs map 13%n = 89concluded
Startup lag
71 dvs map 45.5 dn = 39with dates
Median duration
19.0 mon = 101completed
All sponsors61pain index
Eligibility amendments
38%proxyn = 91sampled
Enrollment failure
17%n = 926concluded
Startup lag
63 dn = 646with dates
Median duration
19.4 mon = 1,313completed
Why these trials stoppedlow accrual leads

The most common category here is low accrual (10 of 19 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 accrual10 (53%)
Sponsor decision3 (16%)
Not reported1 (5%)
Technical or device issue1 (5%)
Change in standard of care1 (5%)
Efficacy or futility1 (5%)
Logistics or operations1 (5%)
Superseded by another study1 (5%)
n = 19terminated or withdrawn
Evidence12 trials

A sample of terminated or withdrawn trials in this cell.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

TrialSponsorStatusStated reason
NCT06181630Bristol-Myers SquibbwithdrawnSuperseded by another study
NCT03858049Merck KGaA, Darmstadt, GermanyterminatedChange in standard of care
NCT03387059Merck KGaA, Darmstadt, GermanyterminatedLow accrual
NCT03210324China Resources Zizhu Pharmaceutical Co., Ltd.terminatedLow accrual
NCT03164551Merck KGaA, Darmstadt, GermanyterminatedLow accrual
NCT03104998PharmEvo Pvt LtdwithdrawnLow accrual
NCT02123992ASTORA Women's HealthterminatedSponsor decision
NCT02121977ASTORA Women's HealthterminatedSponsor decision
NCT02032862A. Vogel AGterminatedLow accrual
NCT01871532Merck KGaA, Darmstadt, GermanyterminatedLogistics or operations
NCT01674283Clinique OvowithdrawnTechnical or device issue
NCT01638767Clinique OvoterminatedLow accrual

Women's & Reproductive Health at other phases