Perspective:

Despite the significant burden of cardiovascular disease worldwide, cardiovascular drug development has not shown growth over the past two decades, and seen relative underinvestment compared with other therapeutic areas. This trend seems to be driven primarily by economic factors, including concerns about return on investment and the perceived investment risk in bringing cardiovascular drugs to market. Using academic collaborations and creative governmental programs to identify and develop potential therapeutic targets through pre-clinical and early-phase development may be a useful strategy to foster cardiovascular drug development. By strengthening and refining the scientific questions and early-phase discoveries, cardiovascular drug development can grow by targeting enriched populations, using novel operational approaches to study design and conduct due to advances in the science of clinical trials, and emphasizing the pursuit of unmet clinical needs. Outcomes research and population health are being streamlined and simplified. Given all these positive changes, cardiovascular drug development could potentially blossom again and improve societal health.