The availability of new therapeutics on the market has been driven by a number of factors including the significant investment in technology, in data linkage and funding. Biomarkers can be a quick way for investors and scientists and funders to make commercial decisions on pursuing a therapeutic target, particularly when clinical trials are expensive and take many years. However it is often unknown how much clinical benefit actually occurs when these therapeutics are released onto the market. Further there are increasing concerns that the improvements in clinical care are not as expected or promised from knowledge of the biomarker. In fact knowledge of both the biology and the clinical pharmacology of these therapeutics suggest some biomarkers are unlikely to be related to therapeutic outcomes. The presentation covers a number of episodes where pursuit of a biomarker reduced access of patient to a drug for which they are likely to have benefited from, or reduced the opportunity for a patient to have a more established therapy more likely to have had benefit. Lessons regarding appropriate use of technology, limitations of biomarkers in clinical outcomes, and how new technologies in linkage with biology and pharmacology could reduce these clinical failures will be summarised.