1. Pharmas will save 90% of costs, but will not discount the drugs accordingly.
2. More new molecules will be put on the market, and will create revenues for the pharmas, just to be pulled out later.
3. Shorter development time will mean more time under patent protection - more profits before generic competition kicks in.
4. More risk will be transferred to the patients.
Because of the lack of concern from physicians (or just laziness) information does not disseminate as quickly as it should. If it did, we would see better resolution in post marketing studies. We need to see better data from these studies if we are going to make a case for putting the drug on the market sooner. The FDA is not simply going to trust a company to keep an eye out. If this is the case, does this mean that pharma will be requesting all patients on this new drug to sign away access to their medical records? If that is the case I'm sure liability language would also be included (just as it would in a trial). Maybe it will save pharma from a few large lawsuits? If so, might that imply a lax environment for their reporting standards?
I really don't see physicians or insurance providers putting in effort that will only help patients and not help their wallets.
If we take what the authors state, namely that 40% of the cost of development is Phase 3 trials, then 60% of the cost is spent even before Phase 3 is entered, and the maximum that could be saved even by doing no Phase 3 studies is 40%. Thus the authors' conclusion that "as much as 90%" of teh development cost could be saved is disingenuous at best - they might as well have said "up to 100%" and it would have been essentially as true, i.e. not true in any reasonable sense.
As for time saving, Phase 3 trials are not quick, though in my experience sponsors try to move them as fast as they can - because they think they have a winner and the sooner they get it approved the better. But a lot of development time - if we define "development" as being from the start of the program to NDA approval, and I think that's how the authors intend it, since they talk about "from bench to bedside" - is spent in hit to lead to preclinical to Phase 1 to Phase 2 before we can even talk about saving of time by reducing the size of Phase 3.
For this, and for a number of the reasons mentioned by earlier commentors, I call BS on this article.