New clinical trials moving to less expensive locations (crosspost)

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http://www.washingtonpost.com/wp-dyn/content/article/2005/05/03/AR2005050301268.html

Clinical Trials of Drugs Fewer, Study Says
Report Also Notes Decline in Number of Principal Investigators in U.S.

By Marc Kaufman
Washington Post Staff Writer
Wednesday, May 4, 2005;

The drug industry is conducting significantly fewer clinical trials of
potential new medicines now than it did in 2001, and the number of
principal investigators leading those efforts in the United States has
declined even more steeply, according to a study by an academic think tank
on drug industry issues.

Using information collected by the Food and Drug Administration,
researchers with the Tufts Center for the Study of Drug Development found
that, after a major expansion during the 1990s, the number of drug
industry-sponsored clinical trials leveled off in 2000 and began to drop
after 2002. Study author Kenneth A. Getz said that the drop was largely
caused by the cancellation of trials entering their final phase.

During that same period, the number of principal investigators leading
clinical trials declined by 11 percent in the United States. The number of
investigators working on FDA-approved trials abroad increased by 8 percent
-- suggesting that the outsourcing of drug research is beginning to
accelerate.

"The big message here is that the decline in principal investigators is
not solely a function of the short-term decline in clinical projects,"
Getz said. "If we continue to see this in the longer term, it could
diminish our ability to innovate."

The Tufts study is believed to be the first to look at overall trends
among FDA-regulated principal investigators and their work. The declines
it found parallel the well-reported drop in innovative new drug
applications being submitted to the FDA and reaching market.

The study also looked at the economics of clinical trials, which are
becoming less lucrative for doctors and researchers. Reflecting that
decline, more clinical trials are being conducted at cheaper sites abroad,
and in southern states rather than in more expensive northern states.
Between 1994 and 2004, the proportion of principal investigators working
in the South grew by nearly 20 percent, to more than 40 percent of the
nation's total. During the same time, the proportion active in the
Northeast declined from 23 to 19 percent of the total.

The study found that the number of female principal investigators is small
and getting smaller. Although 28 percent of all board-certified physicians
were women in 2003, only 12 percent of clinical-trial investigators were
women, a lower percentage than in 1992.

The principal investigators studied are board-certified physicians hired
by drug companies to conduct clinical trials that test the safety and
efficacy of medications in development. Getz and his colleagues examined
the forms each investigator must submit to the FDA describing his or her
work. He found that the number of U.S. principal investigators peaked at
25,000 in 2001 and dropped below 21,000 by 2003.

The number of American sites where clinical trials were underway declined
from about 51,000 in 2001 to 48,000 in 2003. During that same period, the
number of FDA-approved investigational drug studies in all phases of
research rose from about 3,900 to 4,500 -- but with less research being
done at U.S. sites.

Getz said his work and conversations with drug industry officials indicate
that new clinical trials are increasingly being done abroad. He said that
although ongoing clinical trials in the United States are generally not
being moved overseas, the lower costs abroad -- and the often greater
professional and public interest -- are leading many companies to set up
new trials in Eastern Europe, South America and India.

Reflecting this trend, Tadataka Yamada, GlaxoSmithKline's chairman of
research and development, said yesterday that 29 percent of the company's
clinical trials are now done abroad, and that he expects that figure to
jump to 50 percent in two years.

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