Low-value approvals and high prices might incentivize ineffective drug development

Drug regulators’ acceptance of any statistically significant improvement shown in a single randomized trial and lofty drug prices has created a situation where it is now, hypothetically, profitable for a company to run a clinical trials portfolio of chemically inert compounds. While the current cancer drug pipeline is certainly superior to inert drugs, we must rethink market incentives to encourage transformational drug development.

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Author information


  1. Division of Hematology Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA

    • Vinay Prasad
  2. Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR, USA

    • Vinay Prasad
  3. Center for Health Care Ethics, Oregon Health & Science University, Portland, OR, USA

    • Vinay Prasad
  4. Executive Director and CEO of the Institute of Health Economics, Edmonton, Canada

    • Christopher McCabe
  5. Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    • Sham Mailankody


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Competing interests

The authors declare no competing interests.

Corresponding author

Correspondence to Sham Mailankody.