EU lagging US and China on clinical trials – report

Europe has lost command over pharmaceutical clinical trials over the last decade at the expense the market leading US and exponential growth in China, according to a new report by healthcare data company IQVIA. 

Globally the number of commercial clinical trials funded by the pharmaceutical sector has increased by 38% over the past ten years, according to the report, conducted for the European Federation of Pharmaceutical Industries and Associations (EFPIA) and Vaccines Europe.   

However, Europe’s share of this total slumped from 22% in 2013 to 12% in 2023, according to the report, whilst during the same period Asia emerged as a major hub, with China’s share of trial starts increasing from 8% in 2013 to 29% in 2023.    

The region is overtaking established clinical trial centres Europe and North America, where the number of trials fell 10% in each region during the last decade.    

Europe has seen a notable decline in phase 1 trials, designed to assess safety and appropriate dosages, which are often conducted with small groups. This could result in a reduced ‘pipeline’ of future trials in the region, as the knowledge and equipment developed at this stage supports later phases, the report warns.    

In Europe, oncological clinical trials constitute more than 25% of the total trial followed by cardiovascular and rheumatology, on around 10% each. 

The number of European paediatric trials has fallen by 7%, from 142 in 2012 to 75 in 2023 while there has been a steady 4% growth worldwide.  

At the same time, three countries – Greece, Portugal and Slovakia – resisted the overall European trend of decline.    

The report finds Spain – where industry investment in trials increased from €479 million in 2012 to €834 million in 2022 – has emerged as the leader for clinical trial starts in Europe.  

The report attributes Europe’s dipping share of market to several factors, including increasing capacity in third countries, the pandemic’s impact on health systems and economies, and new EU regulations coming into force.  

Most recently, in January 2023, the EU Clinical Trial Regulation came into force, aiming to ensure that the EU provides an attractive and favourable environment for conducting large-scale clinical research, maintaining high standards of public transparency and safety for clinical trial participants.    

But the report suggests this is falling short of the mark, saying “at best, Europe has held, but not improved its position”.    

Other factors impacting the decline are longer trial timelines and patient recruitment, which are slower and longer than in the US, according to the report.   

Trials related to oncology, rare diseases and infectious diseases take longer in Europe than in the US.