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Global Clinical Trial Activity Remained Resilient in 2022 Despite The Continued Pandemic, Says IQVIA Institute

  • In 2022, there was a decline of 1% in non-COVID trial activity compared to 2021, but using 2019 as the pre-pandemic baseline, there was an increase of 8% in trial activity in 2012.
  • Clinical development productivity rebounded dramatically in 2022 with a 27% increase, reversing a 10-year downward trend.
  • The 15 largest pharmaceutical companies together spent a record setting $138Bn on research and development in 2022, up 1.7% from 2021.
  • Despite the increasing sponsor focus on diversity in clinical trials, Black/African American and Hispanic patient representation has declined since 2012.

In 2022, global clinical trial activity remained resilient even as the COVID-19 pandemic stretched through the year, with a 1% decline in non-COVID trial activity compared to 2021. COVID-19 trials as a percentage of total trial activity dropped from 10% to 6% of the 5,756 total trials run in 2022. Non-COVID trial activity increased by 8% between 2019 and 2022, suggesting a restoration to pre-pandemic growth rates, according to a new report, Global Trends in R&D 2023: Activity, Productivity and Enablers, released by the IQVIA™ Institute for Human Data Science. The report also found that clinical development productivity – a composite metric of success rates, clinical trial complexity and trial duration – increased dramatically in 2022, reversing a 10-year downward trend.

“There were a number of uplifting trends in global research and development in 2022. The global R&D ecosystem demonstrated impressive resilience during the continued pandemic with a relatively high level of clinical trial activity. We also witnessed a significant rebound in clinical development productivity, driven by dropping trial complexity and a record level of expenditure by the largest pharmaceutical companies in 2022,” said Murray Aitken, Executive Director of the IQVIA Institute for Human Data Science. “However, more work needs to be done to improve diversity and inclusion of underrepresented populations in clinical trials.”

Additional key highlights of the report include:

  • R&D funding: Biopharma funding – including IPOs, secondary offerings, and venture capital investment – returned to $60.8Bn, just above 2019 levels, after two years of heightened investment during the pandemic. The largest pharmaceutical companies together spent more than $138Bn on research and development in 2022, up 1.7% from 2021.
  • R&D pipeline focus: The research and development pipeline remained flat in 2022, with 6,147 unique products in active development from Phase I to regulatory submission. However, the pipeline has recorded an 8.3% compound annual growth rate over the last five years.
  • Geographic shifts in global R&D pipeline: The total global pipeline has increased by 97% in the last 15 years to 6,147 products in 2022, with significant shifts in geographical contribution. Products from China-headquartered companies now represent 15% of the R&D pipeline, up from 6% five years ago and 2% in 2007. Europe’s share has declined from 31% to 23% over the past 15 years, while U.S. share of the R&D pipeline has remained relatively stable at above 40% over the same period.
  • New drug approvals and launches: A total of 64 novel active substances (NASs) launched globally in 2022, a decline from more than 80 launches in each of the prior two years but representing a return to pre-COVID-19 levels. The decline was driven by a decrease in the number of novel COVID-19 therapeutics and vaccines and fewer U.S. accelerated approvals. A growing share of new launches in 2022 were first-in-class, reflecting the increasing availability of novel science for patients.
  • Clinical development productivity: The Clinical Development Productivity Index — a composite metric of success rates, clinical trial complexity and trial duration — rebounded in 2022, reversing a 10-year downward trend. Trial complexity fell after a COVID-driven peak in 2021, while overall success rates improved slightly. Productivity enablers, including novel trials designs and remote, virtual, or decentralized trials, are playing an increasing role in the biopharma clinical development pipeline.
  • Clinical trial diversity: Despite the increasing sponsor focus on diversity in clinical trials, diversity data reporting, and increased clinical program diversity planning in line with recent FDA guidance, Black/African American and Hispanic patient representation has declined over the past decade. Diverse representation remains below U.S. demographic levels for many therapeutic areas, including cardiovascular, endocrinology, neurology, and oncology.

About the IQVIA Institute for Human Data Science

The IQVIA Institute for Human Data Science contributes to the advancement of human health globally through timely research, insightful analysis and scientific expertise applied to granular non-identified patient-level data.

Fulfilling an essential need within healthcare, the Institute delivers objective, relevant insights and research that accelerate understanding and innovation critical to sound decision making and improved human outcomes. With access to IQVIA’s institutional knowledge, advanced analytics, technology and unparalleled data, the Institute works in tandem with a broad set of healthcare stakeholders to drive a research agenda focused on Human Data Science, including government agencies, academic institutions, the life sciences industry, and payers. More information about the IQVIA Institute can be found at


IQVIA (NYSE:IQV) is a leading global provider of advanced analytics, technology solutions, and clinical research services to the life sciences industry. IQVIA creates intelligent connections across all aspects of healthcare through its analytics, transformative technology, big data resources and extensive domain expertise. IQVIA Connected Intelligence™ delivers powerful insights with speed and agility — enabling customers to accelerate the clinical development and commercialization of innovative medical treatments that improve healthcare outcomes for patients. With approximately 86,000 employees, IQVIA conducts operations in more than 100 countries.

IQVIA is a global leader in protecting individual patient privacy. The company uses a wide variety of privacy-enhancing technologies and safeguards to protect individual privacy while generating and analyzing information on a scale that helps healthcare stakeholders identify disease patterns and correlate with the precise treatment path and therapy needed for better outcomes. IQVIA’s insights and execution capabilities help biotech, medical device and pharmaceutical companies, medical researchers, government agencies, payers and other healthcare stakeholders tap into a deeper understanding of diseases, human behaviors, and scientific advances, in an effort to advance their path toward cures. To learn more, visit


Nick Childs, IQVIA Investor Relations (P)


Trent Brown, IQVIA Media Relations (


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