[joe_the_user]

Very quick searching seems to indicate increased complexity of trials is a big factor. And trials are more complex because most of the drugs being tested are incremental improvements on existing drugs.

“Drugs are more expensive to test when they have smaller effects that require observing more patients for longer periods of time,” [1] Because you have to observe more people over a longer period of time.

That also tempers the article's enthusiasm for biological technologies. The problem with health technology is that every single step is uncertain, every single step needs to be tested. It's "artisanal" to an extreme extent. There is no equivalent to Moore's law. Each step costs more, not less. Well, until we reach the point we can grow who organs easily. Then thing might change.

[1] Title: "From concept to clearance: Why it’s so expensive to develop new CV [cardiovascular] drugs" https://cardiovascularbusiness.com/topics/healthcare-managem...