Analogous statistics have been published regularly since then presenting different perspectives on the return-on-investment theme for large pharmaceutical companies (including additional articles by Munos). The latest of these, a report by Deloitte, declares that 2018 R&D returns have declined from 10% in 2010 to 2% in 2018, the lowest level in nine years (Fig. ). Underlying this is the reported growing cost of bringing a drug to market which at $2.2 billion, is almost double the $1.2 billion recorded in 2010. A useful (and free) statistical overview for CDEV is provided by the Citeline Pharma R&D Annual Review 2018. The good news is that the count of drugs in R&D from just over 4,300 companies has reached 16,181, of which 8,285 are small-molecules. Notwithstanding, circumspection is needed on interpreting this as a distinct molecular structure count since ~40% are blinded code names. Over the past three years rises of 8.4%, 2.7% and 6%, have put 2019 slightly above the three-year mean. Further grounds for optimism is the proportional increase in designations for breakthrough therapies, accelerated approvals and orphan drugs (with some of these three being for rare disease treatments).