Complex Systems with Patrick McKenzie (patio11) We should stop burning pharma trials’ lab notes, with Ruxandra Teslo
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Jan 22, 2026 
Ruxandra Teslo, a researcher devoted to improving biopharma productivity and founder of the Common Technical Document Project, discusses the rising costs of drug development. She explains how clinical trials represent a significant bottleneck, often exacerbated by lengthy timelines and hidden inefficiencies. Ruxandra advocates for public access to regulatory submissions, suggesting that transparency can bridge the knowledge gap and spur innovation. The conversation highlights how small changes can collectively lead to major advancements in the industry.
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Clinical Development Is A Black Box
- There is very little published material explaining how clinical development actually works in practice.
- Knowledge is mostly tacit and confined to people inside companies, creating a black box.
400 Questions Blocking Patient Recruitment
- Patrick described a COVID trial that required a 400-question online questionnaire.
- Recruitment stalled because no one would complete such a long form and the grad student was the only PHP person who could edit it.
Regulatory Filings Contain Hidden Know-How
- Much process knowledge is written into regulatory submissions sent to the FDA.
- Those documents effectively get buried and the field loses actionable know-how.