The super high clinical trial costs also mean problems for any drug that isn't expected to have a large effect size, because it's hard to get statistical signif

The super high clinical trial costs also mean problems for any drug that isn't expected to have a large effect size, because it's hard to get statistical significance. Some trials have been controversially going for a surrogate endpoint, which makes the stats easier since you can get a continuous variable instead of a binary one, but that's also how you get aducanumab, which reduces amyloid plaque, but it's unclear if it actually helps in alzheimers. Despite this they charge $56k a year.