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Tufts CSDD's updated 2024 estimate of the direct cost of a Phase 2 or 3 clinical trial puts it at approximately $40,000 per day, with a single day of delay now worth roughly $500,000 to $800,000 in lost prescription drug or biologic sales, a dramatic increase from the outdated $4 to $5 million per-day-of-delay industry estimate that had circulated since 1993 ( [97] ) ( [98] ), which Tufts characterized as "a gross misestimation for more than 25 years." Every added day spent building a more representative recruitment pipeline therefore carries a real, quantifiable opportunity cost that sponsors must weigh against the scientific and regulatory value of representative data, a tension the still-unfinished Diversity Action Plan guidance leaves unresolved for 2026 planning purposes