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To the Editor.—The Commentary by Drs Thompson and Moskowitz¹ on preserving the clinical research ecosystem should be applauded. In more than 40 years of experience in pharmaceutical research and development, during which I have had the good fortune of seeing 20 new drug products enter the marketplace, I have been impressed with the important impact that good clinical research has on the drug development process. In essentially every instance in which we were able to carry out sophisticated early clinical studies, we markedly shortened the time required for drug development and improved the odds of approval for marketing. It is especially frustrating in this day and age to witness the clash between the high-caliber end points that we are now able to measure in the process of drug discovery and development (eg, cytokine levels, gene function) and available funds to carry out such work.

Financial belt-tightening is occurring across . . . [Full Text of this Article]