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Hepatic Insufficiency

Gastroenterology
26
Pipeline Programs
16
Companies
50
Clinical Trials
0
Approved Products

Pipeline by Development Stage

Preclinical
Phase 1
Phase 1/2
Phase 2
Phase 2/3
Phase 3
On Market
0
26
0
0
0
0
0
Early DiscoveryClinical DevelopmentMarket

Drug Modality Breakdown

Small Molecule
1583%
Peptide
317%
+ 30 programs with unclassified modality

Gastroenterology is a $7.3B market characterized by mature, blockbuster-driven portfolios with near-term patent cliff risks.

$7.3B marketMature→ Stable30 products15 companies

Key Trends

  • AbbVie dominance with 43% of top-10 product spending (LINZESS, CREON, RINVOQ)
  • Guanylate cyclase activators and JAK inhibitors driving innovation in constipation and IBD
  • Multiple patent expirations 2026–2030 creating biosimilar and generic erosion headwinds

Career Verdict

Gastroenterology offers stable, well-compensated roles but limited growth upside; best for risk-averse professionals seeking established markets over innovation-driven career trajectories.

AI-generated market analysis based on FDA, CMS, ClinicalTrials.gov, and hiring data

Market Leaders

#1LINZESSStable
$1.8B
AbbVie·Peak7.4yr
#2CREONDeclining
$1.5B
AbbVie·LOE Approaching
#3XIFAXANDeclining
$1.1B
Bausch Health·LOE Approaching
#4RINVOQGrowing
$976M
AbbVie·Peak11.4yr
#5XELJANZ XRStable
$586M
Pfizer·Peak8.0yr

Drug Class Breakdown

Unknown Mechanism
$2.5B(34%)

mature portfolio anchor

Guanylate Cyclase Activators
$1.9B(27%)

well-established class

Pancreatic Enzymes
$1.5B(20%)

facing biosimilar competition

Janus Kinase Inhibitors
$976M(13%)

growing IBD adoption

Proton Pump Inhibitors
$107M(1%)

commoditized

Career Outlook

Stable

Gastroenterology is a stable, mature market anchored by blockbusters with long patent runways (LINZESS to 2034, RINVOQ to 2038) but faces near-term erosion (XELJANZ 2026). Employment growth is modest and concentrated in device/diagnostic firms rather than pure-pharma. Best for professionals seeking predictable revenue streams over high-risk innovation bets.

Breaking In

Target roles at Roche, J&J, or diagnostic-adjacent firms to maximize hiring volume; pure pharma gastro entry points at AbbVie/Pfizer are limited and highly competitive.

For Experienced Professionals

Leverage gastro expertise in broader GI/immunology roles (Takeda, Novartis) or transition to medical devices/diagnostics where hiring is 3x higher than pharma.

In-Demand Skills

IBD and IBS indication expertiseJAK inhibitor pharmacologyMedical device integration (diagnostics, endoscopy)Generic/biosimilar launch readinessReal-world evidence generation

Best For

Medical Science Liaison (IBD/IBS focus)Commercial Manager (Generic Launch)Clinical Operations SpecialistMarket Access/Reimbursement StrategistRegulatory Affairs (small molecule focus)

Hiring Landscape

$70K-$213K

Total hiring across the gastro ecosystem is 1,818 jobs, dominated by engineering (434) and commercial roles (269). Roche leads absolute hiring at 377 roles, followed by Johnson & Johnson (323) and GE HealthCare (293), reflecting broad medical device and diagnostic involvement alongside pharma. AbbVie's gastro-specific hiring (78 jobs) is modest relative to its portfolio dominance.

1,818
Open Roles
4
Companies Hiring
3
Departments

Top Hiring Companies

377Growing
293Stable
78Stable

By Department

Engineering(24%)
$169K
Commercial(15%)
$176K
Manufacturing(10%)
$213K

Manufacturing and commercial roles command premium salaries ($213K and $176K respectively), but total gastro-pharma hiring is concentrated in Roche and J&J, not pure-play GI companies.

Competitive Landscape

16 companies ranked by most advanced pipeline stage

Prevail Therapeutics
6 programs
6
AbemaciclibPhase 1Small Molecule
EvacetrapibPhase 1
ImlunestrantPhase 1
LY3841136Phase 1
OlomorasibPhase 1
+1 more programs
MSD
MSDIreland - Ballydine
6 programs
6
BomedemstatPhase 1Small Molecule
ElbasvirPhase 1Small Molecule
EnlicitidePhase 1Peptide
MK-0822Phase 1
MK-3866Phase 1
+1 more programs
Sharp Therapeutics
Sharp TherapeuticsPA - Pittsburgh
6 programs
6
BomedemstatPhase 1Small Molecule
ElbasvirPhase 1Small Molecule
EnlicitidePhase 1Peptide
MK-0822Phase 1
MK-3866Phase 1
+1 more programs
Genentech
GenentechCA - Oceanside
2 programs
1
entrectinibPhase 1Small Molecule
IpatasertibPHASE_1Small Molecule
Pfizer
PfizerNEW YORK, NY
2 programs
2
AG-013736Phase 11 trial
CP-690,550Phase 11 trial
Active Trials
NCT00692341Completed24Est. Oct 2008
NCT00969813Completed18Est. Jan 2010
Sandoz
SandozAustria - Kundl
2 programs
2
EverolimusPhase 1
QAB149Phase 1
Acerta Pharma
Acerta PharmaNetherlands - Oss
1 program
1
ACP-196Phase 15 trials
Active Trials
NCT02970318Active Not Recruiting310Est. Oct 2027
NCT02717611Active Not Recruiting60Est. Jun 2026
NCT04898101Completed14Est. Apr 2016
+2 more trials
Mochida Pharmaceutical
1 program
1
FYU-981Phase 11 trial
Active Trials
NCT03306667Completed24Est. Jun 2018
Puma Biotechnology
Puma BiotechnologyLOS ANGELES, CA
1 program
1
NeratinibPhase 1Small Molecule1 trial
Active Trials
NCT00781430Completed27Est. Feb 2010
Boehringer Ingelheim
Boehringer IngelheimINGELHEIM, Germany
10 programs
BI 1015550PHASE_11 trial
BI 10773PHASE_11 trial
BI 1356PHASE_11 trial
BI 1584862PHASE_11 trial
BI 425809PHASE_11 trial
+5 more programs
Active Trials
NCT05661344Completed28Est. Sep 2023
NCT01111318Completed36
NCT02183376Completed33
+7 more trials
Merck & Co.
Merck & Co.RAHWAY, NJ
4 programs
BomedemstatPHASE_1Small Molecule1 trial
ElbasvirPHASE_1Small Molecule1 trial
MK-3866PHASE_11 trial
UlonivirinePHASE_14 trials
Active Trials
NCT07049939Completed9Est. Feb 2026
NCT01797536Completed31Est. Aug 2014
NCT03295266Terminated9Est. Mar 2018
+4 more trials
Bristol Myers Squibb
3 programs
Pharmacogenetics Sampling of the CC-90007-CP-003 Study CohortN/A1 trial
BMS-650032PHASE_15 trials
OnuregPHASE_11 trial
Active Trials
NCT04097704Completed28Est. Nov 2019
NCT01497834Completed224Est. Jun 2013
NCT01455090Completed320Est. Jul 2015
+4 more trials
Debiopharm
DebiopharmSwitzerland - Lausanne
1 program
AlisporivirPHASE_1Small Molecule1 trial
Active Trials
NCT01860326Completed32Est. Sep 2011
X4 Pharmaceuticals
1 program
MavorixaforPHASE_11 trial
Active Trials
NCT06858696Completed39Est. Jan 2026
Novartis
NovartisBASEL, Switzerland
1 program
QAB149PHASE_15 trials
Active Trials
NCT01845623Withdrawn0Est. Dec 2013
NCT01712516Completed1,001Est. Feb 2014
NCT01727141Completed1,042Est. Feb 2014
+2 more trials
Vertex Pharmaceuticals
1 program
telaprevirPHASE_1Small Molecule1 trial
Active Trials
NCT00509210CompletedEst. Jun 2008

Trial Timeline

Clinical trial activity over time

2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
Acerta PharmaACP-196
Acerta PharmaACP-196
NovartisQAB149
NovartisQAB149
NovartisQAB149
NovartisQAB149
NovartisQAB149
NovartisQAB149
Bristol Myers SquibbBMS-650032
NovartisQAB149
Merck & Co.Ulonivirine
Acerta PharmaACP-196
Acerta PharmaACP-196
Acerta PharmaACP-196
Acerta PharmaACP-196

Showing 15 of 50 trials with date data

Clinical Trials (50)

Total enrollment: 9,364 patients across 50 trials

A Study of Acalabrutinib vs Investigator's Choice of Idelalisib Plus Rituximab or Bendamustine Plus Rituximab in R/R CLL

Start: Feb 2017Est. completion: Oct 2027310 patients
Phase 3Active Not Recruiting

Study of Acalabrutinib (ACP-196) Versus Ibrutinib in Previously Treated Participants With High Risk Chronic Lymphocytic Leukemia (CLL)

Start: Jul 2015Est. completion: Jan 2028533 patients
Phase 3Active Not Recruiting

A 12-week Treatment, Multi-center, Randomized, Double-blind, Parallel-group, Placebo and Active Controlled Study to Assess the Efficacy, Safety, and Tolerability of Indacaterol Maleate / Glycopyrronium Bromide in COPD Patients With Moderate to Severe Airflow Limitation

Start: Dec 2012Est. completion: Feb 20141,001 patients
Phase 3Completed

A 12 Week Treatment, Multi-center, Randomized, Double-blind, Parallel-group, Placebo and Active Controlled Study to Assess the Efficacy, Safety, and Tolerability of Indacaterol Maleate / Glycopyrronium Bromide in COPD Patients With Moderate to Severe Airflow Limitation.

Start: Nov 2012Est. completion: Feb 20141,042 patients
Phase 3Completed

Swiss studY for the Treatment of COPD Patients With the Free combiNation of indacatERol and GlYcopyrroniumbromide.

Start: Nov 2012Est. completion: Jun 201479 patients
Phase 3Completed

A Multi-centre Randomized Double Blind 52-week Study to Assess the Safety of QVA149 Compared to QAB149 in Patients With COPD Who Have Moderate to Severe Airflow Limitation

Start: Oct 2012Est. completion: Jun 2014614 patients
Phase 3Completed

Long Term Safety Study of NVA237 vs QAB149 in COPD Patients

Start: Oct 2012Est. completion: Nov 2014511 patients
Phase 3Completed

Comparison of Safety and Efficacy of the Combination Product QVA149A Against the Concurrent Administration of the Individual Components, QAB149 and NVA237, in Patients With Chronic Obstructive Pulmonary Disease (COPD)

Start: May 2012Est. completion: Dec 2012193 patients
Phase 3Completed

A Phase 3 Study in Combination With BMS-790052 and BMS-650032 in Japanese Hepatitis C Virus (HCV) Patients

Start: Jan 2012Est. completion: Jun 2013224 patients
Phase 3Completed

A Study to Assess the Efficacy, Safety and Tolerability of Once-daily (q.d.) QVA149 in Patients With Moderate to Severe Chronic Obstructive Pulmonary Disease (COPD)

Start: Sep 2010Est. completion: Mar 20122,144 patients
Phase 3Completed

A Study of Islatravir (ISL) and Ulonivirine (ULO) Once Weekly (QW) in Virologically Suppressed Adults With Human Immunodeficiency Virus Type 1 (HIV-1) (MK-8591B-060)

Start: Apr 2025Est. completion: Sep 2031150 patients
Phase 2Active Not Recruiting

A Study of ACP-196 (Acalabrutinib) in Subjects With Relapsed/Refractory CLL and Intolerant of Ibrutinib Therapy

Start: Mar 2016Est. completion: Jun 202660 patients
Phase 2Active Not Recruiting

ACP-196 Versus Placebo in Subjects With Rheumatoid Arthritis on Background Methotrexate

Start: Apr 2015Est. completion: Jun 201631 patients
Phase 2Completed

An Open-label, Phase 2 Study of ACP-196 (Acalabrutinib) in Subjects With Mantle Cell Lymphoma

Start: Mar 2015Est. completion: Sep 2026124 patients
Phase 2Active Not Recruiting

An Open-label, Phase 2 Study of ACP-196 in Subjects With Waldenström Macroglobulinemia

Start: Sep 2014Est. completion: Dec 2026107 patients
Phase 2Active Not Recruiting

A Study to Evaluate the Effects of Indacaterol Maleate (QAB149) as a New Formulation in the EPIC Test Fixture

Start: Aug 2013Est. completion: Dec 20130
Phase 2Withdrawn

Study to Determine the Effectiveness and Safety of a Three Drug Antiviral Combination Therapy to Treat Hepatitis C Virus (HCV) Infected Patients Not Previously Treated With Currently Available Medications

Start: Nov 2011Est. completion: Jul 2015320 patients
Phase 2Completed

Study of pegInterferon Alfa-2a, Ribavirin, and Daclatasvir (BMS-790052) With or Without BMS-650032 for Participants in Some Hepatitis C Virus Trials

Start: Sep 2011Est. completion: Dec 2014276 patients
Phase 2Completed

Safety Study of Pegylated Interferon Lambda Plus Single or 2 Direct Antiviral Agents With Ribavirin

Start: Mar 2011Est. completion: Sep 2014165 patients
Phase 2Completed

An Anti-viral Combination Study With Japanese Hepatitis C Infection (HCV) Subject

Start: Apr 2010Est. completion: May 201243 patients
Phase 2Completed

Study of BMS-650032 With Peginterferon Alfa-2a Plus Ribavirin

Start: Feb 2010Est. completion: Oct 2012285 patients
Phase 2Completed

Study to Determine the Effectiveness of Antiviral Combination Therapy to Treat Hepatitis C Virus (HCV) Infected Patients Who Have Previously Failed Standard of Care

Start: Dec 2009Est. completion: Feb 2014215 patients
Phase 2Completed

A Multiple Ascending Dose Study of BMS-650032 in HCV Infected Subjects

Start: Dec 2008Est. completion: Dec 200915 patients
Phase 2Completed

Study to Assess the Safety and Tolerability of Incremental Doses of QAB149 in Adults With Mild-to-moderate Chronic Obstructive Pulmonary Disease (COPD)

Start: Sep 2004Est. completion: Sep 20056 patients
Phase 2Completed

ACP-196 (Acalabrutinib), a Novel Bruton Tyrosine Kinase (BTK) Inhibitor, for Treatment of Chronic Lymphocytic Leukemia, Richter's Syndrome or Prolymphocytic Leukemia

Start: Jan 2014Est. completion: Jun 2027306 patients
Phase 1/2Active Not Recruiting

A Single Ascending Dose Study of BMS-650032 in HCV Infected Subjects

Start: Jan 2008Est. completion: Jul 200824 patients
Phase 1/2Completed

Ulonivirine (MK-8507) in Participants With Mild or Moderate Hepatic Impairment (MK-8507-014)

Start: Jan 2027Est. completion: Jun 202722 patients
Phase 1Not Yet Recruiting

A Study of Ulonivirine (MK-8507) and Methadone in Healthy Volunteers (MK-8507-019)

Start: Aug 2026Est. completion: Jan 202714 patients
Phase 1Not Yet Recruiting

A Clinical Study of Ulonivirine (MK-8507) With Atorvastatin and Metformin in Healthy Adults (MK-8507-018)

Start: Apr 2026Est. completion: Jun 202612 patients
Phase 1Completed

A Study of Bomedemstat (MK-3543) in Participants With Mild or Moderate Hepatic Impairment (MK-3543-023)

Start: Aug 2025Est. completion: Feb 20269 patients
Phase 1Completed

A Study to Test How BI 1584862 is Taken up in the Blood of People With and Without Liver Problems

Start: Aug 2025Est. completion: May 202643 patients
Phase 1Completed

A Study to Investigate Pharmacokinetics (PK) and Safety of a Single Dose of Mavorixafor in Participants With Hepatic Impairment (HI) Compared to Matched Healthy Volunteers With Normal Hepatic Function

Start: Feb 2025Est. completion: Jan 202639 patients
Phase 1Completed

A Study to Evaluate CC-486/Onureg in Participants With Moderate or Severe Hepatic Impairment Compared With Normal Hepatic Function in Participants With Myeloid Malignancies

Start: Jul 2024Est. completion: Apr 20252 patients
Phase 1Terminated

A Study to Test How Iclepertin is Taken up in the Blood of People With and Without Liver Problems

Start: Mar 2023Est. completion: Dec 202329 patients
Phase 1Completed

A Study to Test How BI 1015550 is Taken up in the Blood of People With and Without Liver Problems

Start: Feb 2023Est. completion: Sep 202328 patients
Phase 1Completed

Single-Dose Pharmacokinetics of MK-3866 in Participants With Hepatic Impairment (MK-3866-006)

Start: Dec 2017Est. completion: Mar 20189 patients
Phase 1Terminated

Clinical Pharmacology of FYU-981 (Subjects With Hepatic Insufficiency)

Start: Oct 2017Est. completion: Jun 201824 patients
Phase 1Completed

A Study to Evaluate the Effect of [14C]Acp-196 (Acalabrutinib) in Healthy Adult Participants

Start: Mar 2016Est. completion: Apr 201614 patients
Phase 1Completed

A Study to Evaluate the Effect of an Acidic Formulation of Acalabrutinib (ACP-196), Acidic Beverage, or Grapefruit Juice on the Pharmacokinetics (PK) of ACP-196 Alone and Coadministered With Omeprazole

Start: Jan 2016Est. completion: Mar 201636 patients
Phase 1Completed

A Study to Evaluate the Effect of Hepatic Insufficiency on the Pharmacokinetics (PK) of ACP-196

Start: Oct 2014Est. completion: Feb 201518 patients
Phase 1Completed

Acalabrutinib (ACP-196), a Btk Inhibitor, for Treatment of de Novo Activated B-cell (ABC) Subtype of Diffuse Large B-Cell Lymphoma

Start: Aug 2014Est. completion: Oct 202421 patients
Phase 1Completed

Nintedanib in Volunteers With Hepatic Impairment Compared With Healthy Volunteers

Start: Jul 2014Est. completion: Jan 201533 patients
Phase 1Completed

The Influence of Hepatic Insufficiency on the Pharmacokinetics of Elbasvir (MK-8742) (MK-8742-009)

Start: Mar 2013Est. completion: Aug 201431 patients
Phase 1Completed

Evaluate the Pharmacokinetics, Safety, and Tolerability of Alisporivir in Subjects With Hepatic Impairment Compared to Healthy Subjects

Start: Mar 2011Est. completion: Sep 201132 patients
Phase 1Completed

Pharmacokinetics of Empagliflozin (BI 10773) in Patients With Impaired Liver Function

Start: Jul 201036 patients
Phase 1Completed

Hepatic Impaired Subjects Compared to Healthy Subjects Receiving Multi-dose BMS-650032

Start: Dec 2009Est. completion: Aug 201128 patients
Phase 1Completed

A Safety and Tolerability Study of CP-690,550 in Subjects With Hepatic Impairment and Normal Hepatic Function

Start: Nov 2009Est. completion: Jan 201018 patients
Phase 1Completed

Drug-Drug Interaction Study in Healthy Subjects

Start: May 2009Est. completion: Jul 200928 patients
Phase 1Completed

Study Evaluating The PK And Safety Of Neratinib In Healthy Subjects And Subjects With Chronic Liver Disease

Start: Apr 2009Est. completion: Feb 201027 patients
Phase 1Completed

Pharmacokinetics and Pharmacodynamics of BI 1356 in Subjects With Different Degrees of Liver Impairment as Compared to Healthy Subjects

Start: Jul 200833 patients
Phase 1Completed

Related Jobs in Gastroenterology

Phase Legend

PreclinicalLab & animal studies
Phase 1Safety & dosing
Phase 2Efficacy testing
Phase 3Large-scale trials
On MarketApproved & available

Key Insights

16 companies competing in this space

The information on this page is for informational purposes only and should not be used as a substitute for professional medical advice. Drug information is sourced from FDA, DailyMed, and other government databases. Adverse event data from FAERS does not establish causation. Always consult a healthcare professional for medical decisions.