Decline in commercial clinical trial recruitment selling patients short, says ABPI

The low number of patients recruited, together with slow set-up times, is raising costs and lowering the efficiency of industry clinical trials in the UK. This denies patients the opportunity to participate in cutting-edge clinical research, says the Association of the British Pharmaceutical Industry (ABPI).

Between 2022/23 and 2024/25, the number of patients recruited into UK industry clinical trials fell by 25 per cent, with participation in commercial trials now at its lowest level since 2017/18, according to the ABPI’s annual clinical trials report. [1] [2]

While overall participation in clinical trials in England has increased since the pandemic, only 3.4 per cent of participants in 2024 were recruited into industry trials in the NHS.

Companies point to slow trial set-up times and significantly lower recruitment targets set by UK trials sites, compared to other European countries, as key reasons for the decline. [3]

The Prime Minister has committed to reducing clinical trial set-up times from around 250 to 150 days. This includes three elements: regulatory decisions within 60 days, sites opening to recruitment within 60 days of approval, and first patient recruited within 30 days of the trial opening.

The ABPI report shows that, while regulatory decisions were within their target timeframes, just 27 per cent of UK trial sites opened to recruitment within the 60-day target, and only 41 per cent recruited their first participant within 30 days. [4]

Despite these slow set-up times, there are some encouraging signs of progress. The number of new industry trials initiated in the UK in 2024 rose by 36 per cent (578 trials, up from 426 in 2023), and the UK climbed to sixth place globally for phase III trial starts in 2024, up from eighth place in 2023.

However, the report shows increasing competition from other nations, with China continuing to expand its global dominance in clinical trials, and Spain now the leading country for placing clinical trials in Europe. [5]

Commercial clinical trials generated £7.4 billion for the UK economy in 2022, including £1.2 billion for the NHS. [6]

The ABPI is urging government and NHS leaders to accelerate reforms to trial delivery and increase patient recruitment, to maintain the UK’s global competitiveness.

Dr Janet Valentine, the ABPI’s Executive Director of Research and Innovation Policy said: “Industry clinical trials bring widespread benefits for patients, the NHS and the economy. While the increase in the number of industry trials initiated in the UK is positive, the low number of patients taking part is selling UK patients short of the opportunity to participate in studies of the latest therapeutic innovations, which is especially vital where there are no other treatment options available.

“The government and system partners are working hard to improve the environment for delivering industry trials in the UK. Our report spotlights where these efforts could have the maximum effect, including taking advantage of the unique £300m VPAG Clinical Trials Investment Programme, funded by industry to improve UK commercial trials delivery.”

In the report, the ABPI makes recommendations to address issues within the environment that are making the UK less attractive than its European neighbours. These include:

·      calling for research delivery sites to set and meet higher recruitment targets,

·      the acceleration of set-up times,

·      ensuring executive-level accountability for clinical trials across the NHS,

·      and maximising the opportunity offered by the VPAG Clinical Trials Investment Programme.

Notes to editors
[1] ABPI, UK industry clinical trials: translating actions into impact, Dec 2025, Figure 3
[2] Methodological note: Recruitment data presented in this year’s report includes interventional studies only. Interventional studies are those where participants are assigned to receive one or more ‘interventions’ to evaluate the effects on health outcomes, such as new medicines, devices or procedures.
[3] Where European sites open to recruitment earlier and quickly fulfil or exceed their patient targets, recruitment to the trial may close before UK sites have had a chance to recruit their agreed number of participants. This makes the UK a less reliable location for companies choosing where to run trials.
[4] ABPI, UK industry clinical trials: translating actions into impact, Dec 2025, Figures 4 and 5
[5] ABPI, UK industry clinical trials: translating actions into impact, Figure 1 and Table 1
[6] Frontier Economics, ‘The value of industry clinical trials to the UK’, 02 Dec 2024