China and North America have captured a greater share of clinical trials over the past five years with Europe becoming a less popular location to test drugs.
The trend is highlighted in a new IQVIA report, which looked at how technological, environmental, societal, regulatory, and geopolitical shifts have re-shaped the clinical trial sector, with a particular focus on the locations where studies are being carried out.
According to the authors “The global share of total country-uses per region for trials started in 2023 compared to 2019 reflects a significant amount of shift in regional utilization with Europe, North America, and China as the most utilized regions that have experienced the largest changes.”
The study shows that although Western Europe was the most utilized region in 2023 - with a 25% of country-uses - the relative share of country-uses has dropped by 21% since 2019 — from 32% to 25%.
Similarly, Central and Eastern Europe, which was the third most used region in 2019, is now the fifth largest region for trial activity, and its relative global use share has declined by 33%.
Consolidation of the trial services industry in China and the US is driving this shift, the authors suggest.
“The top 10 most used countries account for 58% of the total average pipeline country use, with the United States and China responsible for 16% and 13%, respectively, of total country-uses for trials started in the 2021–2023 timeframe.
“The next 10 countries are 19% of the country-use share, the next 30 are 20%, and the next 95 countries account for only 3% of the total country uses in 2021–2023.”
Enrollment
IQVIA also looked at how global enrolment rates have changed over the past five years and found that, despite efforts to improve access to drug research, it takes longer to recruit patients today than in 2023.
“Enrollment duration — measured as the time from trial start to enrolment close — for all industry-sponsored interventional clinical trials completing enrolment in the past five years has increased across all phases in that timeframe,” according to the authors.
For Phase I studies enrolment takes an average of five months, which is a 39% increase from 2019 Phase II and Phase III studies saw enrolment duration increase 23% and 16%, respectively.
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