Overcoming the "valleys of death" in advanced therapies: The role of finance.

Advanced therapies are the frontier of medical research and have a relevant therapeutic potential and a profound social value. Despite this, their funding is hindered by many heterogeneous factors that obstruct their translation and survival on the market, even when approved and effective. Using an extensive bibliometric and systematic review of 174 articles published between 2001 and 2023, this study aims to identify the factors hindering the financing of advanced therapies and suggest future research lines to overcome the biomedical and economic "valleys of death". This study is the first review focused on advanced therapies from a financial perspective, and it contributes to advancing scientific knowledge in several ways. First, it highlights that finance academics paid little attention to the topic and most of their contributions are now outdated; therefore, there is the need to explore the new opportunities and solutions offered by financial innovation and the application of new technologies to financial activity. Second, it asks for an interdisciplinary approach to exploring advanced therapies' barriers from a holistic and process perspective and exploiting the social value generated by the development of innovative therapies. Finally, it analyzes the obstacles and value destroyed by the absence of an organic and coordinated process of public intervention, underscoring the imperative for further research to explore new public-private financial models and risk-sharing schemes and extend evaluation models by integrating financial and social value logic.