It’s news to nobody that product launches are taking longer and longer. New product committees in the hospital are designed with the express purpose of separating meaningful innovation from minor incremental changes of little consequence. Commercial stakeholders expressly screen the budget impact of any new product and insist on pricing and pricing stability before the first box enters the facility. The most powerful physicians in the facility are required to justify plans and put trials up for clinical and commercial review. Even a product used in clinical trials must be priced before it can enter some facilities.