Clinical trials have been steadily leaving the UK for years. In 2021, just 2.2% of patients recruited to global trials were from the UK. By contrast, France, which has a similar population size, accounted for 3.9% that year.
That’s not to say we don’t still have some clout (the UK ranks fourth globally for Phase II trials), but the trending outflow needs to be addressed. A lack of testing limits patients’ access to new drugs and means we can’t always be sure what impact treatments will have on our population.
What’s Causing the Outflow?
Pharmaceutical companies are increasingly concerned that seeking UK drug approval is more hassle than it’s worth. We’re a relatively small part of the global picture, and if drugs aren’t tested here and approved for use, it’s not going to torpedo bottom lines in quite the same way that it would in a country the size of the US.
The vast majority of studies conducted in the UK rely on NHS infrastructure –– and the NHS has a reputation for being slow. Clinical trials are incredibly expensive, the latest estimates put them somewhere in the region of $40,000 a day (approximately £31,000), so even a week’s delay is costly. Plus, pharmaceutical companies lose the daily cost of any sales they would have made had the drug not languished at testing, which can also run into the thousands.
So, delays cost money, and the NHS is slow. But clinical trials aren’t the health service’s primary focus and, when faced with mounting pressure post-pandemic, it abruptly pulled the plug on all under-recruited studies in its pipeline. This caused further delays and prompted some pharmaceutical companies to question whether the UK remains a viable destination for testing new medicines.
The UK life sciences industry is clearly in need of support. Enter the Department for Health and Social Care (DHSC), which in August 2024 announced £400 million in funding raised from both the public and private sectors. Initially, three-quarters of the funding was earmarked for establishing 18 Commercial Research Delivery Centres (CRDCs). By December, that number had increased to 20, thanks to a £100 million injection from public-private coffers. Whether this additional investment is part of the initial £400 million or a new commitment remains unclear.
Are NHS-led Solutions Enough?
The plan is for CRDCs to utilise “existing NHS trial infrastructure” to increase clinical trial capacity. These centres are intended to serve as regional hubs, positioning the UK as a leader in delivering trials across therapeutic areas like cancer, obesity, and respiratory disease.
Establishing 18-20 CRDCs – a sizeable clinical trials network – and placing them in rural or underserved areas is a good strategy. Expanding access to clinical trials gives patients more choices and the opportunity to benefit from new and novel therapies. It also improves the diversity of trial participants, which is critical for data collection and, ultimately, delivering better patient outcomes.
However, the focus on NHS-led solutions raises questions. Given the NHS’s resource constraints, is this the right approach? Does it overlook more immediate, effective options?
An Untapped Resource
Setting up CRDCs will take time, but the UK already has a network of dedicated clinical trial sites with the infrastructure, staff, and expertise to deliver results now. These specialist networks are managed by experienced teams who can adapt quickly to evolving trial demands. Unlike the NHS, they are unencumbered by bureaucratic delays and seasonal pressures like winter flu or bed shortages, which can disrupt trial progress. Private networks also benefit from dedicated resources. Purpose-built facilities, experienced staff, and streamlined systems allow them to focus entirely on delivering trials without competing with other healthcare priorities.
But infrastructure isn’t the only issue. The UK’s reputation for reliability took a hit when NHS trials were abruptly halted post-pandemic, leaving pharmaceutical companies hesitant to invest in UK-based studies. Who wants to risk that financial hit when mainland Europe offers more reliable alternatives?
Rather than building state-owned infrastructure from scratch, the Government should focus on measures to reassure pharmaceutical companies that the UK is a reliable and efficient market for testing new medicines. Germany’s national pharma strategy offers a useful blueprint, using pricing incentives and reduced red tape to attract trials.
Addressing Public Concerns
For everyday Brits, clinical trials offer more than just participation. They provide faster access to new treatments and the chance to contribute to life-changing research. Government investment into campaigns that enforce this would not only help with trial recruitment (a major factor for Big Pharma when deciding where to place studies), but could also be used to address concerns around privatisation.
Collaborating with private clinical trial networks doesn’t mean commercialising front-line care or opening the NHS to foreign entities and their shareholders; it means leveraging existing UK expertise to improve patient outcomes. By focusing exclusively on NHS-led solutions and ignoring private sector capabilities, the Government risks creating a costly and inefficient system that disadvantages both patients and taxpayers.
A Balanced Approach
A £400 million investment in life sciences is needed, but it is far from a complete solution. Establishing new research sites alone won’t be enough to rebuild the UK’s credibility with pharmaceutical companies. To truly become a global leader in clinical trial delivery, we need to address systemic issues that have undermined confidence in the market, including resource constraints and a perceived lack of commitment to clinical research.
Outside of Europe, we represent only a small fraction of the global pharmaceutical market. Encouraging drug manufacturers to re-engage with the UK will require a compelling proposition: access to a large, diverse, and engaged patient population alongside fast, reliable trials. That will take a meaningful public-private collaboration — but it needs to focus on leveraging existing strengths and infrastructure, not building entirely new systems from scratch.
Deploying resources where they are most effective and credibly demonstrating government commitment and support for the sector is the only way to guarantee that patients across the country can access the latest medications and therapies.
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To learn more about Velocity’s capabilities across Europe, email Evelyne Newton at enewton@velocityclinical.com.
