As the number of clinical trials has been steadily rising each year, Europe’s share of patient enrollment in them has been on the decline. A new report by IQVIA, prepared for the European Federation of Pharmaceutical Industries and Associations and Vaccines Europe, found that the European Economic Area’s (EEA) share of commercial trials dropped from 22% in 2013 to 12% in 2023, even as the total number of trials increased by 38% throughout the decade.
The EEA includes the countries of the European Union, along with Norway, Iceland and Liechtenstein. IQVIA drew its data from 22 clinical trial registries from around the world.
The report estimated that this drop in trial participation equates to 60,000 fewer European patients enrolled in trials.
Asia’s share in the global trial market, meanwhile, has risen over the same period, with China alone jumping from 8% of total trial starts in 2013 to 29% in 2023. This boost may be due to China’s large number of possible patients, a growing number of Chinese companies sponsoring trials and the expansion of the country’s National Reimbursement Drug List, the report said.
China’s trial growth is largely driven by single-country trials held only within its borders, the report noted. EEA trials, in contrast, have been stable over time. More than two-thirds of trials in the EEA are multi-country, with most single-country trials on the continent taking place in France, Germany and Spain.
The EEA’s shrinking piece of the clinical trial pie may be due to its lengthy timelines, IQVIA said. Across oncology, infectious disease and rare disease areas, clinical trial timelines in the EEA were longer than in comparable trials in the United States. This was mainly seen in longer site startup and patient recruitment times. There is variation across Europe, though, as Poland, Spain and Denmark had faster recruitment rates, on par with the United Kingdom, which departed the EEA when it left the European Union in 2020.
To fix Europe’s declining trial participation, IQVIA offered some insights based on Spain and Denmark. These two nations are strong performers compared to the rest of Europe, per the report, due to their proactive investment in commercial partnerships, healthcare infrastructure and research centers across major cities.
In another possible remedy to the EEA’s dropping trial share, late last month, the European Clinical Trials Information Network rolled out its patient recruitment platform across Europe, with the goal of enabling decentralized trials. Decentralized trials are growing in popularity in the U.S., but aren’t yet common in Europe.