540 Chemie
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Clinical development is historically the phase in which a potential new medicine is being tested in phase 2 and phase 3 patient trials to demonstrate the new molecules' efficacy and safety to support the regulatory approval of drugs by health authorities. This relatively focused approach has been considerably expanded by a number of forces from within the pharmaceutical industry and equally important by changes in the healthcare systems. The need to identify the optimal patient population, showstoppers leading to discontinuation of clinical programs, the silent but constant removal of surrogate endpoints for registration, and the increased demand for real-life data which are used to demonstrate the patients' benefit and which have an ever-increasing role for pricing and reimbursement negotiations are today an integral part of this phase.
This chapter will review both the nuts and bolts of clinical development but also recent developments in this area which shape the environment and how the different players have reacted and what options might need to be explored in the future.
It is known that the costs related with drug research and development (R&D) and the timelines to develop a new drug increased over the past years. In parallel, the success rates of drug projects along the pharmaceutical R&D phases are still very low, and the outcome of all R&D efforts is stagnating. In consequence, the R&D efficiency defined as the financial investment per drug has been steadily decreasing. As innovation is the major growth driver of the pharmaceutical industry, reliable data on R&D efficiency and new concepts to overcome these challenges are of great interest for R&D managers and the sustainability of the pharmaceutical industry as a whole. This book chapter reviews publications on R&D performance indicators of the past years, such as the success rates and timelines per phase. Additionally, it illustrates the factors influencing the success rates, timelines, and costs of pharmaceutical R&D most and, thus, the denominators of the R&D efficiency.
The efficiency of pharmaceutical research and development (R&D) reflected by increasing costs of R&D, long timelines, and low probabilities of technical and regulatory success decreased continuously in the past years. Today, the costs for discovering and developing a new drug are enormously high with more than USD 2 billion per new molecular entity (NME), while the average overall success of a research project to provide an NME is in the single-digit percentage rate, and the total timelines of R&D easily exceeds 10 years questioning the return on investment (ROI) of pharmaceutical R&D. As a consequence and also caused by numerous patent expirations of blockbuster drugs that increased the pressure to return to an acceptable ROI, the pharmaceutical industry addressed this challenge and the related causes and identified several actions that need to be taken to increase the output/input ratio of R&D. This book chapter will review the pipeline sizes and the R&D investments of multinational pharmaceutical companies, will describe new processes that have been implemented to increase the reach and to reduce costs of pharmaceutical R&D, and it will illustrate new innovation models that were developed to increase the R&D efficiency.