The UK's clinical trial landscape is facing a critical challenge, as revealed by the Association of the British Pharmaceutical Industry (ABPI). The latest data shows a fourth consecutive year of declining participation in commercial clinical trials, a trend that threatens the country's research competitiveness and patient access to cutting-edge treatments. But what's driving this downward spiral? And what can be done to reverse it?
The ABPI's report highlights a concerning paradox: while the overall number of interventional research participants has risen, the proportion of people recruited for commercial trials has plummeted. In 2024/2025, only 3.4% of NHS research participants were enrolled in commercial trials, down from 10.3% in 2017/2018. This decline is attributed to a combination of factors, including slow trial setup times and low patient recruitment numbers, which are making the UK less attractive for commercial research compared to its European and international counterparts.
The report also underscores the impact of workforce challenges on trial site selection. Virtually all surveyed companies reported gaps in the NHS workforce, including pharmacists, which have negatively affected UK site selection. This highlights the need for targeted investment in the pharmacy workforce to ensure sufficient capacity for research participation.
To address these issues, the ABPI recommends setting more ambitious recruitment targets for commercial clinical trials and prioritizing their achievement. However, the report also warns of 'perverse incentives' in performance reporting that may deter NHS organizations from setting high recruitment targets, fearing failure to meet them. This creates a vicious cycle that hinders progress.
The situation is further complicated by the government's lack of clarity on how it plans to utilize the Voluntary Scheme for Branded Medicine Pricing, Access and Growth (VPAG) investment program funds to tackle workforce challenges. This uncertainty exacerbates the urgency of the situation, as the UK strives to maintain its global leadership in life sciences.
The Royal Pharmaceutical Society's chief scientist, Amira Guirguis, emphasizes the importance of streamlining trial processes and investing in the pharmacy workforce to increase participation. She also stresses the need for inclusive and representative recruitment to ensure that clinical trial populations reflect the diversity of the communities they serve. By enabling more patients from all backgrounds to join clinical trials, we can advance care, support the NHS, and strengthen the UK's life sciences sector.
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 will be crucial in reversing the decline in commercial clinical trial participation and ensuring the UK's continued competitiveness in the global research arena.
