The most transformative drugs of the past 25 years: a survey of physicians


Strategic and legislative efforts to catalyse pharmaceutical innovation may be hampered by a lack of consensus over what characterizes an innovative drug. To help clarify this issue, we conducted an extensive survey on transformative drug development, involving 180 expert physicians based at 30 leading US academic medical centres, covering 15 medical specialties. In an iterative Delphi process, the survey participants narrowed a list of all new drugs approved in their fields in the past 25 years and reached consensus over those that they considered to be most transformative, which are presented in this article. Participants were also asked how various factors affected their opinion; they most often invoked the effectiveness and superiority of the drugs over existing alternatives when identifying transformative drug innovation.

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The authors thank C. Stark and V. Gillet for their assistance with the research. The authors also express their appreciation to the 184 physician experts from 30 clinical institutions who participated in the survey that formed the basis of this report.

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Correspondence to Aaron S. Kesselheim.

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The authors declare no competing financial interests.

Supplementary information

Supplementary information S1 (table)

Lists of potentially transformative drugs presented to survey participants in the medical specialties (PDF 360 kb)

Supplementary information S2 (box)

US-based academic medical centres from which the survey participants were recruited (alphabetical order) (PDF 254 kb)

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Kesselheim, A., Avorn, J. The most transformative drugs of the past 25 years: a survey of physicians. Nat Rev Drug Discov 12, 425–431 (2013).

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