> ## Content Index
> Fetch the complete content index at: https://chivanta.com/llms.txt
> Use this file to discover other available public pages before exploring further.

# Got a great new drug? Don’t go chasing the biggest market just yet!
- URL: https://chivanta.com/clinical-efficacy-commercial-value/
- Published: 2026-09-04T08:02:02.000Z
- Updated: 2026-09-04T08:02:02.000Z
- Description: A large patient population does not automatically mean a large commercial opportunity. Two stories illustrate why drug developers should prioritize competitive advantage and unmet medical needs, not simply the biggest market.
- Author: ShaoChi CHENG
- Tags: Business, Strategy

Over ten years ago, I attended a business seminar hosted by Academia Sinica in Taiwan. The speakers included an Academia Sinica researcher and a VC investment manager, with about 20 attendees in the room.

The VC manager shared a story with us: an entrepreneur once pitched him, saying, "The global motherboard market is worth over $10 billion. Fund my factory, and if we capture just 0.01% of that market, we'll be swimming in money!" The VC manager gave a bitter smile, shook his head, and told us:

> Here's the reality, if your motherboard has nothing that sets it apart, you won't capture any market at all, because nobody's going to buy it from you.

Years later, working in BD at a pharma company, I had a conversation with a scientist developing an antibody drug. He came out with a very similar (and equally flawed) idea: "My new drug can treat cancer. If we target breast cancer or colorectal cancer, which have the largest patient populations, we’ll make a lot of money!"

His logic was simple: biggest patient population = biggest market; biggest market = biggest business opportunity. Hmm... sounds reasonable on the surface, but it's not that simple.

Let's set aside for a moment whether the tumor actually expresses the specific target for his antibody, and the usual gap between animal models and human response.

> Here's the reality: breast cancer and colorectal cancer have already been divided into different patient subgroups based on tumor characteristics, and each subgroup has its own first-line treatments. If your drug cannot deliver better outcomes than the existing treatments, your new drug simply won’t get a chance to treat these patients.

💡

That means ****Clinical Efficacy ≠ Commercial Value**

I was too polite at the time, even though we had good relationship, I didn't dare to say "you idiot...". I could only politely say "maybe pick the cancer type with the most treatment potential first, see how it perform and then decide what's next..." (Hmm… I today would probably be more direct. XD)

These two stories are basically the same. You can't assume that just because the global motherboard market is worth $10 billion, grabbing 0.01% of it will make you rich. Same with the drugs. You can't assume that just because a disease has a huge patient population, your new drug automatically has commercial value. Because:

**A big market does not mean you can actually get into it.**

**Whether it’s a drug, a motherboard, or any other product, the market will not buy from you if you don’t have your own competitive advantage.**

> For drugs specifically: if you've got real data showing your new drug beats the current first-line standard, and your funding is deep enough, then go for it; go head-to-head with a standard of care, and run a head-to-head clinical trial. No ambiguity, win or lose, plain and simple. But if you're not sure yet, find a disease or subpopulation with no adequate treatment option, treat that first. If the results are strong, expand into other indications later. That's the more realistic path.

If you don't have the evidence yet, don't get greedy and aim straight for the biggest market from day one because **you might end up clinically effective but worth nothing commercially.**

Drugs are like any other product. A big market doesn't mean you can actually get in. **Find the unmet medical need first, and it will be your commercial niche.**

Got a great new drug? Don’t go chasing the biggest market just yet!