Patients missing out as industry clinical trial recruitment falls for fifth year in a row

Despite continued improvements in the speed of trial setup, the number of people taking part in industry clinical trials in the UK has fallen for the fifth year in a row, meaning fewer patients had the chance to take part in research into the latest treatments. The Association of the British Pharmaceutical Industry (ABPI) says urgent action is needed.

Industry clinical trials bring major benefits to patients, the NHS and the economy. In 2022, they were worth £7.4 billion to the UK economy, including £1.2 billion for the NHS. [1]

The ABPI's latest annual clinical trials report published today shows that just 17,618 people took part in industry clinical trials in the NHS in 2025/26, down from 19,507 the year before. This is 31 per cent fewer than in 2022/23. [2] Only 3.8 per cent of interventional clinical trial participants were recruited to industry sponsored studies, a proportion which was consistently higher than 10 per cent pre-pandemic. [3]

The government has pledged to double the number of people taking part in industry trials by 2026, and to double it again by 2029, an ambition strongly supported by the ABPI [4]

There has been real progress on setting up industry trials faster, particularly at the regulatory stage of set-up. In August 2026, every study got an approval decision within 60 days. [5]

However, following regulatory approval, the time it takes for studies to open to recruitment is still a concern, as is the time taken to recruit the first patient, and to open all sites in a trial. In 2025/26, an average of 35 per cent of studies opened to patients within 60 days of approval, against a target of 90 per cent. Just over half (53 per cent) recruited their first patient within 30 days of opening. [6][7]

The report shows a positive trend that the UK's Commercial Research Delivery Centres (CRDCs), funded as part of the VPAG Investment Programme, are outperforming the wider UK ecosystem on set-up and delivery measures of clinical trials. In 2025/26, 75 per cent of CRDC studies were open to recruitment within 60 days of approval, compared to 58 per cent of all UK sites. [8]

The report also highlights initiatives which show early signs of driving further efficiencies in study setup. This includes an improved National Contract Value Review process, which has reduced the time it takes to finalise contracts and costing for participating trial sites from 65 days to 25 days (a 62 per cent reduction). [9]

Joe Edwards, Executive Director of UK Competitiveness at the ABPI said: "Industry clinical trials give patients the opportunity to take part in research into the latest innovative treatments, sometimes when there are no other options available. The fact that UK recruitment continues to fall is worrying.

"The government, regulators and the NHS have made real progress on speed of set up, but the full benefit is only realised by patients, the NHS and the economy when speed is followed by recruitment. Companies invest in clinical trials where every site can open quickly and recruit reliably. The UK must now deliver that across the whole trial, not just at the first site."

The UK's global position is mixed in terms of numbers of industry clinical trials started. In 2025, the UK ranked seventh in the world for starting phase I trials, it ranked fifth for phase II and seventh for phase III. [10]

The ABPI's report makes five recommendations to governments across the UK, the NHS and industry. These are:

• expand UK Clinical Research Delivery metrics and research delivery funding to support study delivery across all sites and incentivise more ambitious and predictable recruitment

• set up a UK-wide service that uses NHS data to help find and enrol suitable patients for trials

• measure and report on the diversity of clinical trial participants, to make research more inclusive and representative

• strengthen the UK's viability as a trial location by ensuring the medicines access and adoption environment gives patients globally competitive care, delivered through the commitment to double innovative medicines spend by 2036

• reinvest income from industry trials in research staff and facilities, so the UK's trial system can pay for itself in the long term