Clinical trial launches level out after pandemic highs, dropping 15% YOY

The pace of clinical trial starts is leveling out, dropping below pre-pandemic highs with a 15% decline in 2023 compared to the year before.

A third (32%) of the overall clinical trial slowdown is due to a drop in COVID-19 activity, according to a new report from the IQVIA Institute for Human Data Science. Trial starts dropped 22% from peak pandemic-related trial activity in 2021, according to the “Global Trends in R&D 2024: Activity, Productivity, and Enablers” report. The analysis counted both planned and actual trial starts for 2023.

Early-phase trial launches decreased the most in 2023, with 19% fewer phase 1 starts compared to 2022. Meanwhile, phase 2 activity dropped by 11% and phase 3 trial starts declined by 15% in 2023.

Over the last decade, emerging biopharmas have increased their share of early-phase trials, which could be due to a shift in M&A in which deals now typically occur later in development stages, according to IQVIA. In contrast, large pharmas account for 27% of trial starts, up 3% from 2022 but down drastically from 50% in 2014.   

When examining trial starts by indication, the majority (79%) of last year’s launches were in oncology, immunology, metabolic/endocrinology and neurology. Trials in these four spaces, alongside rare disease, declined less than in other areas.

Alongside the rising popularity of Novo Nordisk’s Wegovy and Ozempic, obesity clinical trials skyrocketed 68% from 2022. According to IQVIA, there are 124 obesity drugs in active development, 40% of which are GIP/GLP glucagon receptor agonists.