Look back at key pipeline trends from the last12 months so you can forecast success in 2024 Contents Welcome Introduction: Total Pipeline Size05Pleasant outlook for pharma as things continue to heat up Developing Systems: The 2024 Pipeline by Phase08Clinical development advances still face a stiff headwind Top Companies11Some enjoy a moment in the sun, but for others the future looks more hazy Therapies and Diseases19Cancer still taking R&D by storm Regional Variations31Where the outlook seems to be brightest Mechanisms and Targets54Immuno-oncology makes hay while the sun shines Types of Pipeline Drugs59Is the continued move into biotech starting to meet a frosty reception? What’s the Forecast for Pharma?62Plenty of rays of sunshine should hold off any storm clouds on the horizon About the Author Welcome Welcome to Pharmaprojects’ 2024 review of trends inpharmaceutical R&D Welcome to Pharmaprojects’ 2024 reviewof trends in pharmaceutical R&D. For over30 years now, I’ve been taking an annuallook at the evolution of pharma R&D, and inthis article I’ll take the temperature of theindustry at the start of 2024. We’ll assessindustry trends by examining the pipeline bycompany, therapeutic area, disease, target,and drug type, using data primarily fromPharmaprojects, part of the Citeline suiteof products, which has been tracking globaldrug development since 1980. This report willbe followed up by our annual supplementreviewing the New Active Substance (NAS)launches for the year just passed. But here,we’ll examine how the pharma R&D climate ischanging, look at where the pressure is risingand falling, and try to determine where theoutlook is sunny and where storm clouds aregathering. Hopefully, it will help you to takethe industry’s temperature and forecastits outlook. Since our early cave-dwelling days, the activitiesof humanshave been somewhat governedby the vagaries of the weather. We needed toknow when conditions were best for hunting,and whether our crops would flourish or fail. Theearliest attempts to predict the weather werelargely unscientific and based on prophecy,astrology, or prayers to invisible weather gods.As with so many things, the ancient Greeks werethe first to turn superstition into science, andin fact the term “meteorology” comes from theGreek meaning “the study of things high in theair.” The acknowledged father of the scienceis Aristotle, who published a treatise on thesubject as early as 350 BC. Of course, accurateinstruments to measure weather-relatedphenomena only really came along with theEnlightenment, but weather forecasts were stillnotoriously unreliable, especially in countries likethe UK where I am based, as little as 50 yearsago. It was only with the growth of computingpower, and with it, computer modelingalgorithms, that forecasters were able to providepredictions with any measure of certainty. Thekey, as always, is data — and lots of it. My hopeis that this report will fulfill the same function:it will provide enough information for you todetermine which parts of the industry arelikely to be basking in unbroken sunshine,and which are preparing for a period ofunsettled conditions. Regular readers of this report (which has beenrunning since 1993, so is presented here in its32ndedition) will know that, in recent years, I’vethreaded a different theme through each edition,to highlight points, to draw analogies, and toadd a little character into what could otherwisebe a rather lengthy narrative through a paradeof statistics, charts, and tables — duller than aDecember day in Doncaster. Themes selected sofar have included astronomy, movies, the naturalworld, music, food and drink, science fiction,travel, and, last year, literature. This year, as youmay have guessed, I decided to hang my (rain)hat on something thataffects us all every day:the weather, and the allied most important issueof our times, climate change. While our primary focus is naturally on theshort term; i.e., whether we need to put on anextra jumper or to bring our umbrellas, thelong-term trends are what exercise the mindsof both climate scientists and pharma industryfollowers. In the past few decades, the topic ofthe weather has grown from being a parochialconsideration to something threatening our veryexistence. But, in fact, the idea that our impacton the planet is changing it irrevocably has beenaround longer than you might think. It was atthe end of the 19th century when scientists firstpredicted that changes in atmospheric carbondioxide levels could substantially alter a planet’ssurface temperature through the greenhouseeffect, and just prior to World War II when GuyCallendar connected carbon dioxide increasesin Earth’s own atmosphere to global warming.Particularly since the turn of the millennium, theevidence seems irrefutable that, unless action istaken and taken fast, we are building towards athreat to our continued existence. The pharmaindustry has of course weathered a more acuteexistential threat rec