Evidence map›Paper›PMID 32125404›Full record

ArticleJAMA2020

Estimated Research and Development Investment Needed to Bring a New Medicine to Market, 2009-2018.

Olivier J Wouters, Martin McKee, Jeroen Luyten

Erratum issuedAbstract read
In one paragraph

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.

0numbers the graph read from it
0cells of the map it votes in
631citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

631 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. 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 · 2026
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  8. Drug repurposing in hereditary ataxia.npj drug discovery · 2026
    Review
  9. Effects ofPain reports · 2026
    Article
  10. 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 · 2026
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571 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors.

Olivier J WoutersDepartment of Health Policy, London School of Economics and Political Science, London, United Kingdom.
Martin McKeeDepartment of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Jeroen LuytenLeuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven, Belgium.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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.

Indexed as

Drug DevelopmentDrug IndustryPharmaceutical ResearchClinical Trials as TopicCosts and Cost AnalysisDrug CostsUnited StatesUnited States Food and Drug Administration

Identifiers

PMID32125404
PMCPMC7054832

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.