Ep. 104: Ruxandra Teslo: Clinical Trials, Drug Innovation, and the Bottleneck to Biotech Abundance

In this episode, she and Niklas explore why drug development takes over a decade, why only ~10% of drugs reach approval, and how clinical trials have become one of the biggest bottlenecks to biomedical progress.

They unpack how incentives distort which diseases get treated, why surrogate endpoints matter, and how off-label use, real-world data, and even “bro science” reveal gaps in the current system.

They also cover: • Clinical evolution and iterative human testing • Regulatory opacity and open-sourcing FDA filings • Australia’s faster Phase 1 model • Human challenge trials and medical freedom • Surrogate endpoints and distorted incentives • Real-world data and off-label discovery • Biotech innovation shifting to China • How better trials unlock biomedical abundance

A conversation for anyone interested in biotech, policy, and the future of drug development.

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