ArticleJAMA2020
Estimated Research and Development Investment Needed to Bring a New Medicine to Market, 2009-2018.
Article in JAMA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 631 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
631 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- The role of AI-assisted drug repurposing in neurological disorders: a systematic review of validation strategies, challenges and opportunities.Journal of nanobiotechnology · 2026Pooled it
- Integration of microphysiological systems with computational and digital twin modeling for pharmaceutical development: a systematic review.Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques · 2026Pooled it
- Faster but Not Truer, Part 2: The Regulatory Record, the Economics, and the TRACE-HEOR Reporting Standard.Journal of health economics and outcomes research · 2026Pooled it
- Identification of genetically-supported new drug targets for osteomyelitis based on druggable genomes.Human genomics · 2025Pooled it
- Regulatory and clinical outcomes of priority-reviewed innovative cancer drugs in China between 2015 and 2024: an observational study.BMC cancer · 2025Pooled it
- Investigator-Initiated Trials as a Clinical Development Approach for Orphan Drugs Compared with Industry-Sponsored Trials in Japan.Therapeutic innovation & regulatory science · 2026Article
- Article
- Drug repurposing in hereditary ataxia.npj drug discovery · 2026Review
- Effects ofPain reports · 2026Article
- Evidence-steered medicine in oncology: network-aware micro-combinations that safeguard standard of care and potentially improve benefit-risk.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Review
- Bridging the divide between health economics and outcomes research and biomedical investment: reflections from a health economist working in venture capital.Journal of comparative effectiveness research · 2026Review
- Red lines and green lights: Gene therapy for inherited erythroid disorders beyond the haemoglobinopathies.British journal of haematology · 2026Review
- New thinking for the next generation of antimalarials.EMBO molecular medicine · 2026Review
- Clinical trials in a dish: cardiometabolic drug development with biological and digital twins.The Journal of clinical investigation · 2026Review
- Drug Brand Switching: A Regulatory Perspective.Drug safety · 2026Review
- Deep learning extracts MoA-specific signatures from high-throughput images of chemically and genetically perturbedScience advances · 2026Article
- MEGPNM as a multiscale edge-aware GAT network with hybrid pooling predicting permeability of non-peptidic macrocycles.Communications chemistry · 2026Article
- Article
- Leveraging neural network models for drug repurposing: a case study on cardiac hypertrophy.Scientific reports · 2026Article
- Therapeutics candidates and repurposing strategies to target parkinson's disease pathology: current evidence and future directions.Metabolic brain disease · 2026Review
571 more citing papers are in PubMed but not listed here.
Corrections and comments
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- Erratum issued
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
importanceThe mean cost of developing a new drug has been the subject of debate, with recent estimates ranging from $314 million to $2.8 billion.
objectiveTo estimate the research and development investment required to bring a new therapeutic agent to market, using publicly available data. DESIGN AND
settingData were analyzed on new therapeutic agents approved by the US Food and Drug Administration (FDA) between 2009 and 2018 to estimate the research and development expenditure required to bring a new medicine to market. Data were accessed from the US Securities and Exchange Commission, Drugs@FDA database, and ClinicalTrials.gov, alongside published data on clinical trial success rates. EXPOSURES: Conduct of preclinical and clinical studies of new therapeutic agents. MAIN OUTCOMES AND MEASURES: Median and mean research and development spending on new therapeutic agents approved by the FDA, capitalized at a real cost of capital rate (the required rate of return for an investor) of 10.5% per year, with bootstrapped CIs. All amounts were reported in 2018 US dollars.
resultsThe FDA approved 355 new drugs and biologics over the study period. Research and development expenditures were available for 63 (18%) products, developed by 47 different companies. After accounting for the costs of failed trials, the median capitalized research and development investment to bring a new drug to market was estimated at $985.3 million (95% CI, $683.6 million-$1228.9 million), and the mean investment was estimated at $1335.9 million (95% CI, $1042.5 million-$1637.5 million) in the base case analysis. Median estimates by therapeutic area (for areas with ≥5 drugs) ranged from $765.9 million (95% CI, $323.0 million-$1473.5 million) for nervous system agents to $2771.6 million (95% CI, $2051.8 million-$5366.2 million) for antineoplastic and immunomodulating agents. Data were mainly accessible for smaller firms, orphan drugs, products in certain therapeutic areas, first-in-class drugs, therapeutic agents that received accelerated approval, and products approved between 2014 and 2018. Results varied in sensitivity analyses using different estimates of clinical trial success rates, preclinical expenditures, and cost of capital. CONCLUSIONS AND RELEVANCE: This study provides an estimate of research and development costs for new therapeutic agents based on publicly available data. Differences from previous studies may reflect the spectrum of products analyzed, the restricted availability of data in the public domain, and differences in underlying assumptions in the cost calculations.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.