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Developing new, effective pharmaceutical compounds is a fundamentally difficult task.
Starting with challenges identifying promising treatment targets and potential compounds, to ensuring the drug can be properly delivered within the body, the scientific work that needs to go well is massive.
The regulatory and market conditions in which they exist add to this difficulty. 
For example, regulations are designed to reduce the number of drugs released to market
with significan issues, such as in the case of VIOXX \cite{krumholz_whathavewe_2007}
or the Perdue Pharma scandal \cite{officepublicaffairsjusticedepartment_2020}.
These regulations, such as clinical trial standards \todo{add citation to clinical trials here}, 
increase the costs of developing new drugs, adding to the business conserns already present, including 
competitors already in the market or close to entering and the overall demand to address a given condition.

%begin discussing failures
%I am thinking I'll discuss marketing and operational failures
%I somehow need to step away from the drug development framing and soften it to ... what? drug investigation?

While discovering that a drug doesn't work or is unsafe is a scientific failure, other failure modes occur.
\cite{khmelnitskaya_competitionattritiondrug_2021} explored how to identify business related failures within the drug development pipeline. 

Thoughts so far
types of failure: 
- scientific: unsafe or ineffective
- business: concerns about profitability
- operational: cannot actually complete the steps required to bring things to market.

Things that influence each
- scientific: phamokynetics, biology. Take as given.
- business: regulation, competitors, demand levels, patents, etc
- operational: regulation, finding participants, finding competent PIs etc.

Maybe financial and operational terminology?

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