Hi SUA -
To build on Nate's Point there appears to be a series that NEJM (New England Journal of Medicine) is Publishing on challenges of conducting clinical studies in industry - last month they did one from a big pharma perspective which i posted elsewhere on teh forum, and this month (published earlier this week) they published another from the view of small biotech Company - the article's author focuses his examples from a Rara Disease perspective.
Here is the reference - good reading
The Changing Face of Clinical Trials: Drug-Development Challenges for Small Biopharmaceutical Companies
R.A. Moscicki and P.K. Tandon | N Engl J Med 2017;376:469-474
Between this and last months article you start to get a Picture at the later end of development of what's going on out there.
I'm i a small pharma that fills its porfolio either by licensing-inalready marketed products or late stage products that are on cusp of getting regulatory approval - so for us our challanges are more like the big pharma ones clinical study wise. I cant' talk much to this particular article but go back to last months issue and find that article on the view from large pharma and I can talk to that more.