Biotech IndustryAdvanced~20 min

Drug Development Pipeline

Why a drug costs billions and probably fails anyway

Set success probabilities, costs, and timelines for each clinical phase, then compute the true cost per approved drug and the risk-adjusted NPV that decides go/no-go.

The takeaway

The billion-dollar price tag is not the cost of the drug that worked. It is the cost of the drug that worked plus the nine that didn't — and that division is the whole business model.

Probability of successAttritionPhase II failureCapitalized costRisk-adjusted NPVPatent cliff
Read the theory: Gene Therapy Delivery

A generic small-molecule programme. Phase I → approval lands near the famous ~7–10%.

Value the programme as of
Investors do not value a drug from the beginning of time — they value it from where it stands today. Sunk cost is gone; only the remaining odds, spend and time count.
Phase I → approval
7.4%
the number everyone quotes
Discovery → approval
1.45%
1 in 69 programmes
Out-of-pocket cost
$460M
one clean run, no failures
Cost per approved drug
$2.83B
including the failures
rNPV at Ph I entry
$38M
GO — value creating
Stage parameters

Click a stage to tune its probability of success, cost and duration. Defaults are approximate published ballparks (Tufts/DiMasi, BIO–Informa success-rate reports) rounded for teaching.

~100–500 patients. The first honest test of whether the drug does anything. This is where the industry's dreams go to die — the lowest probability of success of any stage.

reach this stage: 10.1% · from here to approval: 14.3% · 7.0 entries per approval
Commercial assumptions
Standing at Phase I — Safety
Remaining PoS → approval7.4%
Remaining spend / time$420M · 8.7y
Peak-year operating profit$750M/yr
NPV if it works (no risk adj.)$1.32B
rNPV (risk-adjusted)$38M
Break-even peak sales$1.01B/yr

rNPV = Σ (cash flow × probability of reaching it) ÷ (1 + 11%)t, with t measured from Phase I — Safety and mid-year discounting. Break-even peak sales is solved, not guessed: rNPV is linear in peak sales, so the peak revenue at which rNPV = 0 is just the risk-adjusted PV of costs divided by the risk-adjusted PV of revenue per $1M of peak. At industry-average odds it lands near $1.01B — which is precisely why the industry only chases blockbusters.

Attrition compounds

5,000 programmes in → 72.5 approved drugs out

Target
1,750 killed
3,250
Lead
1,625 killed
1,625
Preclin
650 killed
975
Ph I
468 killed
507
Ph II
360 killed
147
Ph III
62 killed
85
Review
13 killed
72
Launch
0.0 killed
72
survivors leaving each stage · log-scaled widths · faded bar = programmes that entered
StagePoSEnterSurviveKilledEntries / approvalCost carried
Target Discovery65%5,0003,2501,75069.0$345M
Hit / Lead Discovery50%3,2501,6251,62544.8$448M
Preclinical60%1,62597565022.4$560M
Phase I — Safety52%97550746813.5$404M
Phase II — Efficacy29%5071473607.0$490M
Phase III — Confirmatory58%14785622.0$507M
Regulatory Review85%8572131.2$24M
Approval & Launch72720.01.0$50M
True cost per approved drugΣ (stage cost × entries needed per approval)$2.83B
Where the billion dollars comes from

A single successful programme only spends $460M out of pocket. But to get one drug through, you must start 69 discovery programmes, 13.5 Phase I trials and 2.0Phase III trials — and the survivor's price has to pay for all of them. Charge each stage its cost times the number of attempts it takes, and the true cost per approval is $2.83B 6.1× the direct cost. Published headline figures ($1–3B) additionally capitalise this at a cost of capital over 10+ years, which pushes it higher still.

The three lessons
Attrition multiplies
No single stage has hopeless odds — 52%, 29%, 58%, 85% — but you must pass all of them. Multiply and Phase I → approval is 7.4%. Probability chains are why the industry looks irrational from the outside and merely expensive from the inside.
The valley of death
Move the valuation anchor to Target Discovery: rNPV goes −$11M. Move it to Phase III: $938M. Same drug, same science — only the resolved risk differs. Early assets are worth almost nothing on paper, which is exactly why good biology starves between the lab and the first patient.
The exclusivity clock
The patent starts running years before the first patient is dosed. Every year of delay is a year sliced off the selling window, not added to the end. Drop exclusivity from 11 to 8 years and watch the rNPV fall — that is the same arithmetic that drives accelerated approval, priority review vouchers, and the fight over patent cliffs.
Default probabilities, costs and durations are approximate published ballparks(e.g. Tufts CSDD / DiMasi et al.; BIO–Informa–QLS clinical success-rate analyses; Wong, Siah & Lo 2019), rounded for teaching. Real figures vary enormously by indication, modality and sponsor. Costs are out-of-pocket in constant dollars; the headline "$2.6B per drug" figures additionally capitalise spend at a cost of capital, which this model does not do — so treat the cost-per-approval here as a floor.