TFPA Discussion Paper

The Unmeasured Years

Why great launches still keep patients waiting, and the case for a common measure of Time to First Patient Access.

A considered, fully referenced look at the gap between approval and the first patient actually receiving a therapy, what that wait costs, why it persists, and what artificial intelligence is about to do to the whole picture.

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No form, no sign up. Nine pages. Every material figure referenced.

Cover of The Unmeasured Years discussion paper, click to download the PDF

What is inside

The paradox of the celebrated launch, told through Trikafta and its four very different market clocks.
The systemic evidence: the EFPIA access data, plus Zolgensma and CAR T as parallel cases.
What a day of delay actually costs, and why a shorter patent runway makes it cost more.
Why the delays persist: the expert view on pricing, assessment and launch sequencing.
What AI does to the picture, and the asymmetry it creates.
The case for a shared, forward looking measure of launch success.

A few of the numbers

532 days

Median wait from approval to patient access across Europe (EFPIA W.A.I.T. 2025).

~$500k

Peer reviewed estimate of the cost of a single day of launch delay (Tufts CSDD, 2024).

28%

Share of new medicines fully available on public reimbursement lists, down from 42% in 2019.

25% to 50%

Estimated AI time and cost savings in discovery to preclinical (BCG and Wellcome, 2023).

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