Policy and Practice

Exploring innovation in health and medicine, and the institutions, incentives, and infrastructure that drive it.

By Adam Kroetsch

· Launched a year ago

Clinical trial innovations don't scale. Here's why, and how to fix it.

A Policy Agenda for Efficient, Abundant Clinical Trials

Jun 8 • Adam Kroetsch

Who Owns the FDA's Thinking?

A law firm says that FDA’s rejection letters reveal too much. That may be exactly why the public needs them.

Jun 1 • Adam Kroetsch

FDA’s Real-Time Clinical Trials Pilot Could Transform Drug Development

The approach is promising. The challenge is scaling it up.

Published on The Clinical Trials Abundance blog • May 12

Clinical Trials Were Not Always This Complicated

How trials got so bureaucratic, and how some leaders pushed back

Published on The Clinical Trials Abundance blog • Apr 9

To fix trials, we need to pay attention to the boring stuff

Trial operations are getting less productive and more expensive. That needs to change.

Mar 9 • Adam Kroetsch

Will Bayesian Statistics Transform Trials?

FDA has finally published its Bayesian guidance. Will it matter?

Published on The Clinical Trials Abundance blog • Feb 16

Introducing the Clinical Trials Efficiency Project

To make clinical trials faster and less costly, we need system-level reform

Feb 2 • Adam Kroetsch

How The FDA Remade Drug Development

My new article in Asterisk Magazine

Dec 23, 2025 • Adam Kroetsch