The UK's clinical trial landscape is facing a critical challenge: a fourth consecutive year of declining participation in commercial trials, according to the Association of the British Pharmaceutical Industry (ABPI). This trend threatens the country's position as a leading research hub, with potential consequences for both the healthcare system and the economy.
The ABPI's report reveals a paradox: while the overall number of trial participants has increased, the proportion of people recruited for commercial trials has dropped significantly. In 2024/2025, the total number of trial participants reached 453,276, a positive sign. However, the report highlights a concerning shift: only 3.4% of research participants were enrolled in commercial trials, down from 10.3% in 2017/2018. This decline raises concerns about the UK's competitiveness in the global clinical trial market.
The report emphasizes the need for urgent action by the government and NHS leadership. It underscores the importance of commercial trials in generating income for the NHS and enabling patients to access cutting-edge medical research. The ABPI suggests that the slow trial setup process and low patient recruitment numbers are contributing to rising costs and reduced efficiency, making the UK less attractive compared to European and international competitors.
One key factor identified is the shortage of healthcare professionals, including pharmacists, in the NHS. This workforce gap has negatively impacted site selection for clinical trials. The report calls for a more proactive approach to addressing these workforce challenges, particularly regarding the use of funds from the Voluntary Scheme for Branded Medicine Pricing, Access and Growth (VPAG) investment program.
To combat this, the report recommends setting more ambitious recruitment targets and prioritizing their achievement. It also highlights the need to overcome 'perverse incentives' in performance reporting, which may discourage NHS organizations from aiming high. Amira Guirguis, chief scientist at the Royal Pharmaceutical Society, echoed these concerns, emphasizing the impact on patient access to innovative treatments and the financial sustainability of NHS services.
The government's Life Sciences Sector Plan, published in July 2025, sets an ambitious goal of reducing trial setup times to under 150 days. Achieving this target is crucial for the UK's position in the global life sciences arena. The plan also highlights the financial benefits of commercial trials, with NHS trusts earning £26,311 per patient enrolled in 2022/2023.
In conclusion, the ABPI's report serves as a wake-up call, urging the government and NHS to take decisive action. By addressing workforce shortages, streamlining processes, and setting clear recruitment goals, the UK can ensure its continued success as a leading destination for commercial clinical trials, ultimately benefiting both patients and the healthcare system.
