80-85% of clinical trials fail to meet enrollment targets, with 30% of trial sites recruiting zero patients, causing $8M/day revenue losses for sponsors

Clinical trial sponsors -- particularly mid-size biotech companies running Phase II and III trials -- face a systemic patient recruitment crisis where the vast majority of trials cannot enroll enough participants on schedule, and a large fraction of activated investigator sites never recruit a single patient. Why it matters: 80-85% of trials miss initial enrollment projections, so 9 out of 10 trials ultimately double their original timeline to meet enrollment goals, so sponsors lose an estimated $8 million per day in delayed revenue during the enrollment extension period, so total drug development costs escalate dramatically beyond already high baselines ($2.6B average per approved drug), so promising therapies reach patients years later than they could, and some programs are abandoned entirely due to unsustainable burn rates. The structural root cause is that trial site selection relies on investigators' optimistic enrollment estimates rather than data-driven patient availability modeling, patients are unaware trials exist (less than 5% of adult cancer patients participate in trials), and overly restrictive eligibility criteria exclude large portions of the patient population who could safely participate -- all compounded by fragmented health data systems that prevent sponsors from identifying eligible patients at scale.