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For all NTDs approved between 2021–2023, the average and median peak sales forecasts are US$1.5 billion and US$0.5 billion, respectively, matching the long-term average and median. When COVID-19 vaccines and treatments are excluded, the average drops to US$1.0 billion for the same time frame, and the median stays almost constant at US$0.5 billion. For products approved in 2023 in particular, the average falls below US$0.8 billion when COVID-19-related products are excluded, nearing just 50% of the long-term average of US$1.5 billion.

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The paper is rather dry, but the conclusion, that products launching now are forecasting $0.5bn to $1bn sales per year, means that those products must be under water for most of their marketed lives, once R&D and Commercial costs are considered.

The 56.48 metres of the title is the world record for swimming under water - it’s one of those odd records that is a lot less than you might imagine… Two lengths of a swimming pool is the most anyone has ever achieved in the whole of recorded human history.

Of course, for most companies, most of their pipeline doesn’t launch, so water is all there is. But, until the glorious fresh clear air is achieved, there’s nothing to reinvest in another excursion under water. So it is for many companies now, who are looking at increasingly desperate measures to find ‘blockbuster’ drugs - that used to mean $1bn drugs, but $1bn revenue per year for 5-9 years is rather close to the line now.