A dynamic map for learning, communicating, navigating and improving therapeutic development

Drug discovery and development is a highly challenging process ( Nat. Rev. Drug Discov. 9 , 203–214; 2010) 1 . Its common characterization as a 'pipeline' connotes consistent unidirectional flow of a candidate therapeutic in unchanged form from basic research discovery to drug to utilization, in stark contrast to the diverse web of failure-prone iterative learning loops that, in reality, must be traversed by scientists, physicians, regulators, payers and patients to develop and use new treatments 2 . This deeply engrained misnomer contributes to the lack of public understanding of the drug development process, with implications for science and public policy, and leads to actions that may fail to improve, and perhaps even worsen, the process.