British patients risk missing out on cutting-edge drugs following a collapse in the number of trials

British patients risk missing out on cutting-edge drugs following a collapse in the number of new clinical trials, industry leaders warn. 

The UK initiated more trials for Covid treatments than any other European country but those for other diseases have plummeted. 

The Association of the British Pharmaceutical Industry says studies here were hit harder than in other nations and have been slower to recover. 

It insists ministers must do more to make the country an attractive place to do trials, so patients can access the newest medicines faster. 

Recommendations include embedding a research culture within the NHS, streamlining the trials approvals process and increasing funding to regulators. 

The UK initiated more trials for Covid treatments than any other European country but those for other diseases have plummeted (stock)

There were 68 commercial clinical trials for Covid initiated in the UK in 2020 – the most in Europe and third only to the United States and Brazil. 

However, the focus on Covid has negatively impacted on research across other diseases, including cancer, heart disease and diabetes. 

More than 40 per cent of NHS trusts had non-Covid research studies paused during the first wave of the pandemic, preventing patients from receiving potentially life-saving treatments.

UK global ranking for clinical trials

UK’s 2021 global ranking

Phase 1 – 4 

Phase 2 – 5 

Phase 3 – 7 


UK’s 2018 global ranking 

Phase 1 – 3 

Phase 2 – 2 

Phase 3 – 4

The UK initiated 655 commercial clinical trials in 2018 but this fell 33 per cent to 440 last year, excluding those for Covid. 

This means the country has slipped down the global league tables for phase 1, 2 and 3 clinical trials, the new ABPI report reveals. 

Richard Torbett, the association’s chief executive, said: ‘We are proud of the achievements in Covid-19 research, but we must now learn from them if we are to rebuild and transform the UK’s whole clinical research offering. ‘

The value of clinical research has never been more evident – it is the key to global recovery, improving public health and protecting us from future pandemics.’ 

Overall clinical trial enrolment in the UK was 84 per cent lower in May 2020 than May 2019, with cancer studies suffering the biggest dip of 88 per cent. 

France, Germany and Spain saw overall enrolment fall between 66 and 70 per cent in May 2020, while Italy’s biggest year-on-year drop of 60 per cent was recorded in April. 

Italy and Spain have recovered their non-Covid research activity the fastest, with enrolment 37 per cent and 34 per cent higher, respectively, in June 2021 than June 2019. 

Meanwhile, enrolment in the UK is still floundering 15 per cent lower than pre-Covid levels. 

The UK is relatively strong in early clinical research and maintains its place as number one in Europe for Phase 1 clinical trial activity. 

However, its global ranking has dropped from third in 2018 to fourth in 2020. 

For Phase 2, the UK ranks third in Europe and fifth globally – down from first and second, respectively.

However, for later stage Phase 3 trials, which see larger numbers of patients treated with potentially life-saving treatments, the UK has dropped behind a number of European countries. 

For these, it now ranks just seventh globally and fifth in Europe – behind USA, Spain, Germany, China, Italy and France. 

Professor Ramesh Arasaradnam, Academic Vice-President of the Royal College of Physicians, said: ‘Clinical trials have played a crucial role in the development of new vaccines and treatments for Covid-19, demonstrating the importance of research for all to see. 

‘At the same time, the disruption that the pandemic has caused to other areas of clinical research is very concerning. 

‘It is imperative that we return levels of research activity to at least what they were before the pandemic. 

‘Participating in non-Covid-19 trials is potentially transformative for patients’ health and wellbeing. 

‘Putting research at the heart of the NHS’s recovery will help deliver better outcomes for patients, improve job satisfaction within the workforce and benefit the UK economy. 

‘It must be a key priority for policy makers as we emerge from the pandemic.’ 

The number of people participating in clinical trials in England in 2020/21 was double that in 2019/20, however 905,790 of the 1,390,483 were participating in Covid research. 

Commercial clinical research generated an estimated income of £355million for the NHS in England in 2018/2019 and an estimated cost saving of £28.6million. 

Russell Abberley, an ABPI board member and General Manager for UK and Ireland at drug’s firm Amgen, said: ‘Global pharmaceutical companies are looking for the optimal environment to conduct their clinical trials; places where they can cultivate strategic partnerships and innovate in clinical development in a timely manner. 

‘The UK needs to demonstrate it can deliver that. 

‘Putting the recommendations of this report into action will help make the UK a leading destination for researching and developing new medicines, with compelling treatment benefits for patients and economic advantages for the NHS.’ 

Hilary Reynolds, chief executive of the Association of Medical Research Charities, described the pace of the UK’s recovery relative to other countries as ‘concerning’. 

She added: ’It is clear that substantial and sustained investment and collaboration across the research and healthcare systems is required, with an active and resourced commitment from Government to fulfil their aim for the UK to be a science superpower.’