Faster drug approvals, real-time release, regulatory relief. These, and many other benefits, are promised by adopting Pharmaceutical Quality by Design principles. So why aren't more people embracing the concept? Skeptics continue to see QbD efforts as too expensive, time consuming and impractical, while QbD and PAT projects are being launched separately, rather than together as intended. Exploring the reasons for this apparent disconnect, and potential solutions, are Ali Afnan, Pedro Hernandez-Abad, Sam Venugopal and Gawayne Mahboubian-Jones.