UK clinical trials performance improves but remains in intensive care

In its annual report on the health of UK industry clinical trials, the Association of the British Pharmaceutical Industry (ABPI) found that the UK is making progress toward rebuilding its global position as a desirable location for placing industry clinical trials [1].

Between 2017 and 2021, the UK fell from fourth to tenth place in the global rankings for the number of phase III trials it hosts.

Today, the UK has started to climb the rankings again, up two spots to eighth place for the number of phase III trials. However, the UK remains below similar European countries like Spain (3rd), Germany (6th) and Italy (7th). [2]   

The UK also gained two places for phase II trials, moving from sixth to fourth, but fell one place in the phase I rankings down to fifth place.

For the second year in a row, the total number of industry clinical trials initiated in the UK increased, up from 411 trials in 2022 to 426 in 2023. These studies generate new treatments and interventions for patients and create valuable revenue for the NHS.

The number of phase III trials, the stage closest to a treatment being approved for patients, also showed growth. These increased by 16.5 per cent since 2022, from 182 to 212. However, the number of phase II trials initiated in the UK in 2023 remained flat year on year, and initiations of phase I trials, were down by 26.6% from 79 to 58.

The number of participants recruited into interventional industry clinical trials fell by 13.8 per cent from 25,730 to 22,191 in 2023/24. This is the lowest number of individuals participating in industry trials over the past seven-year period.

 Overall recruitment to commercial research studies increased from 44,564 in 2022/23 to 150,191 in 2023/24; however, this was due to a small number of commercial observational research studies, which together recruited upwards of 100,000 people.

To accelerate progress towards achieving these benefits, the report makes six key recommendations:

1. The £300 million VPAG Clinical Trials Investment Programme should be invested in line with pharmaceutical industry expectations to boost capacity and infrastructure – for example, in the recently announced Commercial Research Delivery Centres (CRDCs).
2. In implementing improvements in the UK clinical trials environment, the government should prioritise reducing set-up times for trial delivery
3. The route for industry engagement with the UK clinical trials delivery system must be streamlined and integrated to avoid repeated conversations with different parts of the system
4. Research should be embedded as business as usual in the NHS, offering every patient the opportunity to participate in studies of novel treatments and cutting-edge interventions.
5. The government and NHS should publish a research workforce plan to improve clinical research delivery within the NHS.
6. System partners must expedite increased transparency and accountability for UK clinical trial performance through standardisation, timeliness and consistency of performance reporting.

Commenting on the report, Richard Torbett, Chief Executive of the ABPI said: “It’s promising to see that positive government action in response to earlier decline is beginning to pave the way to industry clinical trials recovery, although the UK still has a long way to go to return to its previous globally leading position.

“We urge the government and delivery partners to focus on the recommendations set out in our report to accelerate progress. Positioning industry clinical research as a key element in the forthcoming Life Sciences Sector Plan and NHS 10 Year Plan will send a signal to global industry that the UK is open for business again.”

Increasing industry clinical trial activity in the UK can play a significant role in realising the government’s missions for health and economic growth, benefitting individuals and society. Research-active hospitals are associated with better patient outcomes, and industry clinical trials bring significant benefits to the UK economy, the NHS and productivity.

In 2022, industry clinical trials contributed £7.4 billion (GVA) to the UK economy, supporting 65,000 jobs and generating £1.2 billion of revenue for the NHS, which created over 13,000 NHS research-linked jobs. If the UK could return its industry clinical trial activity to the levels last seen in 2017, it could generate an additional £3 billion of GVA and support 25,000 new jobs, including £485 million of NHS revenue and 5,000 clinical research jobs in the NHS.[3]

Globally, the UK has one of the highest potentials for growth in industry clinical trials in the world, particularly for large-scale, late-phase clinical trials.[4] It will be important for the UK to capitalise on this potential at a time when trials are pivoting away from Europe.[5] Public enthusiasm for clinical research is high, with 76 per cent saying they would support their MP campaigning for their local hospital to deliver more trials. [6]