Which biotechs are the least efficient?

SmartTrend has looked at the biotech industry to determine which companies are the least efficient. Using revenue per employee (RPE)--a ratio useful when comparing a company against others in its industry--SmartTrend found the five public companies that have the lowest efficiency relative to the size of their workforce. As is the case for many biotechs, these companies have little or no revenue but have spent million of dollars--and multiple years--moving drugs through the clinical trials process.

1. MannKind (MKND, RPE of $0K): Valencia, CA-based MannKind is developing an inhaled insulin product called Afrezza, which it hopes can revolutionize how diabetes is treated. MannKind has gone back and forth with the FDA over Afrezza data and is now anticipating a decision on the drug in late December. In 2008, MannKind had one of the largest R&D budgets in all of biotech.

2. Orexigen Therapeutics (OREX, RPE of $1K): Orexigen is one of three companies trying to get weight-loss drugs to the market. It's lead program is the weight-loss, diabetes and depression drug Contrave. Despite promising clinical data, the drugmaker faces an uphill battle gaining approval for its drug for obesity--an area which has been plagued by safety issues.

3. Aastrom Biosciences (ASTM, RPE of $3K): Aastrom is developing a drug for congestive heart failure using cardiac repair cells, which contain stem and early progenitor cells extracted from the patient's marrow. The FDA has twice place a clinical hold on a Phase II trial of the drug, but both times it has been lifted.

4. Cell Therapeutics (CTCI, RPE of $3K): The FDA recently rejected Cell Therapeutics' NDA for Pixuvri (pixantrone) for relapsed or refractory aggressive non-Hodgkin's lymphoma. The agency doubted whether the drug was effective and was underwhelmed by the company's ability to enroll just 140 of a planned 320 patients in the trial. New trials of the drug are planned, but Cell Therapeutics cut 36 employees following the FDA's decision.

5. Hemispherx Biopharma (HEB, RPE of $4K): Last year the FDA issued a demand for more information from a new, 300-person trial of Hemispherx's for chronic fatigue syndrome drug Ampligen. Hoping to overcome the FDA's concerns, Hemispherx submitted new preclinical data for the drug to regulators and is still awaiting an FDA decision. The drug has been in development for 20 years.

- here's the ranking