Pharma Intelligence’s report on 2021 Completed Trials” report, indicates apparent green shoots of Covid-19 recovery in clinical trials across the pharmaceutical industry.
According to market numbers and the 2021 completed trials report 4,109 industry-sponsored clinical trials have moved from phase I through to phase III/IV and have either reached completed trial status or reported primary endpoints during 2021. This exceeds the 3,777 trials in 2020 and represents an 8.8% annual increase, and doubles the growth rate observed in the pre-pandemic period from 2017 through 2019.
Oncology continued to be at the top spot among rankings of therapeutic areas for completed trial activity in 2021. For the first time, infectious diseases (ID) shot from fifth into second place owing to considerable Covid-19 pandemic-related trial activity.
The autoimmune/inflammation (A/I) attained the third rank, while central nervous system (CNS) and metabolic/ endocrinology (Met/Endo) dropped into fourth and fifth places, respectively. cardiovascular (CV) has been seen to decline in completed trials observed since 2018. Vaccines, which often overlap with ID trials, retained their seventh position while completing substantially more trials in the past year. The smallest therapeutic areas, ophthalmology and genitourinary (GU), are trending in opposite directions with modest changes in their trial counts.
Despite the turbulence caused by the pandemic, the leading clinical trial sponsors achieved success rates comparable to those in 2019 in trials conducted across a wide array of rare and prevalent diseases, where the top three therapeutic areas are oncology, infectious diseases, and autoimmune/inflammation. These companies continue to focus on global trials, although the increased domestic trial activity by Chinese sponsors is now making a mark on overall completed trial trends.
The expected distribution of trial counts by phase was observed with fewer later phase trials completing than those of earlier phases across therapeutic areas. This trend towards growth in earlier phases of research and reductions in larger clinical trial completions indicates that the pandemic recovery is still ongoing, with the multi-year timelines of phase III trials in particular more prone to disruption.
The 2021 counts were also augmented by increased activity captured from Chinese registries. These trials are generally run exclusively in China. Most of these trials, ranging from 67.5% to 82.1% for mid-sized therapeutic areas and 55.0% for oncology, are phase I or phase I/II studies, a factor that accounts for most of the growth in that phase observed during this period.
Even as smaller pharma companies possess an increasing share of clinical activity, Bristol Myers Squibb, AstraZeneca, Merck & Co., Pfizer, and Novartis continue to occupy the top five positions in completed trials.
Although the top 20 pharma increased its overall completed trial counts (1,612 versus 1,575), the relative contribution to overall completed trials dropped from 41.6% to 39.6%. Within the individual clinical stages, the proportion of All Other Pharma (AOP) sponsorship in Phase I was higher than observed in earlier analyses. These shifts are mainly driven by the increased influx of Chinese phase I trials. Despite the shift towards smaller clinical trial sponsors, Bristol Myers Squibb, AstraZeneca, Merck & Co., Pfizer, and Novartis continues to occupy the top five rankings for annual completed trial activity.
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