An oncology leader views AI's most powerful near-term application as handling tedious logistical and bureaucratic tasks, not discovering novel molecules. By automating paperwork and trial planning, AI can liberate scientists to spend more time on deep, creative thinking that drives breakthroughs.

Martin Shkreli argues that the primary bottleneck in drug development isn't finding new molecules, but the immense inefficiency caused by poor communication, irrational decision-making, and misaligned incentives across numerous human departments. He believes AI's greatest contribution will be optimizing this complex organizational process rather than just improving discovery.

Tech-focused venture firms are finding their AI investment thesis fails in biotech. Despite massive paper profits in tech AI, their biotech AI portfolios show negative returns. This is because AI has yet to solve the complex biological bottlenecks of drug development, particularly in clinical trials, which remain slow and costly.

In high-stakes fields like pharma, AI's ability to generate more ideas (e.g., drug targets) is less valuable than its ability to aid in decision-making. Physical constraints on experimentation mean you can't test everything. The real need is for tools that help humans evaluate, prioritize, and gain conviction on a few key bets.

While AI holds long-term promise for molecule discovery, its most significant near-term impact in biotech is operational. The key benefits today are faster clinical trial recruitment and more efficient regulatory submissions. The revolutionary science of AI-driven drug design is still in its earliest stages.

While AI can accelerate the ideation phase of drug discovery, the primary bottleneck remains the slow, expensive, and human-dependent clinical trial process. We are already "drowning in good ideas," so generating more with AI doesn't solve the fundamental constraint of testing them.

Despite AI's power, 90% of drugs fail in clinical trials. John Jumper argues the bottleneck isn't finding molecules that target proteins, but our fundamental lack of understanding of disease causality, like with Alzheimer's, which is a biology problem, not a technology one.

The process of testing drugs in humans—clinical development—is a massive, under-studied bottleneck, accounting for 70% of drug development costs. Despite its importance, there is surprisingly little public knowledge, academic research, or even basic documentation on how to improve this crucial stage.

While AI is on the verge of cracking preclinical challenges, the biggest problem is the high drug failure rate in human trials. The next wave of innovation will use AI to design molecules for properties that predict human efficacy, addressing the fundamental reason drugs fail late-stage.