Report: CROs should consider Asian countries as trial sites for these reasons

Asian countries have become more popular among CROs to set up their trial sites.

Patient recruitment has been named as a key factor for clinical trial failures and delays, and many CROs are turning their studies to vast populated Asian countries, boosting the region’s trial industry, a recent Frost & Sullivan report finds.

The consulting firm predicts that the global clinical trial market will grow from 2015’s $31.8 million to an estimate of $57.0 billion in 2020, a compound annual growth rate of 12.4%. Even though the Asia-Pacific market (only consists of those countries in the western section of the Pacific Ocean) will still only take up less than 18% of that global market in 2020, Frost & Sullivan sees it grow at a much faster rate of nearly 20%.

The recent report (PDF) depicts Asia as a newly emerged preferred destination for clinical trials, primarily because of many treatment-naïve patients, which could be a huge incentive for faster recruitment.

The region is home to around 4 billion people, among whom around 2 billion live densely in urban areas, contributing to more than half of the world’s urban population. In comparison, clinical trials are much sparsely carried out in those countries. For example, the clinical trial density (as in the number of recruiting sites divided by the country’s population in millions) in China and India—the world’s two largest populated countries—were only 2.0 and 0.5, compared with the U.S.’ 166.0 and the U.K.’s 64.4, per the report’s calculation.

This means there’s a large patient pool waiting to be utilized by clinical trials, a situation ideal for speedy patient recruitment.

Besides, some Asian countries show higher prevalence in some therapeutic areas. For example, according to a 2014 study published in the World Journal of Gastroenterology, more than 50% cases of gastric cancer occur in Eastern Asia. In the meantime, Asian countries are showing similar or even higher incidence rates of some of the major diseases experienced in Western countries, including cardiovascular diseases, lung cancer and rheumatoid arthritis, etc.

Even in areas where the rates are comparably low in Asian countries, the actual number of patients might still be considerably larger than in the U.S. and Europe, given its large population base. Compared to the lack of patients in the U.S. and Europe, “the high incidence and prevalence of certain diseases in Asian countries make the region extremely attractive for conducting clinical trials,” says the report.

Practice makes perfect, and that also holds true for clinical trials. Another upside related to large numbers of patients is the skills and experience physicians gained through treatments, as well as proper infrastructure, especially in wealthier metropolitan areas.

The National Taiwan University Hospital, for example, has a strong expertise in cardiovascular treatments. It carried out more than 500 heart transplants as of 2014 with a success rate exceeding 90%, the report says. Because of friendly government regulations and funding, China is also an industry leader in stem cell therapy, with 17 academic institutions and hospitals that conduct all together 72 ongoing researches in the field. Including those experts in trials is also quite beneficial.