If you can think of a way that you can have a much higher chance than 9% of success in getting a useful treatment to market, you can make a boatload of money. Go ahead, reform it.

It's not for lack of trying. People are definitely trying to find better ways of finding stronger candidates earlier. People are trying to gain a more precise understanding of disease mechanisms.

There are breakthroughs that I could have never imagined such as mRNA vaccines.

You can go make literally a trillion dollars if you can come up with an alternative.

How? He’s saying that he can’t think of any good ones, and in my experience that’s true of most informed people. This is one of those hard problems that needs solutions, and so far the present system is the best anyone has managed.