With Canada already one of the least popular places in the world to conduct clinical trials, Canadian labs face significant challenges to bring future trial work home. Canada faces competition from developed economies and developing countries, where the costs of conducting trials is lower, finding patients to volunteer for drug testing is easier, and regulation is simpler.Lowly rankedCanada’s ranking as a place to conduct clinical trials has dropped steadily over the last five years. Between 2006 and 2010, the number of clinical trials and trial sites in Canada dropped approximately 30 per cent, with clinical trial applications for non-generic drugs decreasing to 596 from 777.
This flight of research from Canada sparked industry, academia and government to gather in Ottawa in September 2011 for the first Canadian Clinical Trial Summit. There, industry and policy-makers discussed Canada’s downward trend and worked on an action plan to improve Canada’s competitiveness.
The issue of Canada’s weakened competitiveness is not a new one. According to an article in the January 2009 Canadian Medical Association Journal, many people involved in clinical trials believed that cost and conflicting requirements were among the causes for the Canadian system’s disarray. In the article, Ronald Heselgrave, chair of the ethics board at the University Health Network, said there is the fear that once clinical trials leave Canada they will be difficult to get back. This fear may be the new reality. Clinical trials continue to decline, and there is little incentive for companies to come to Canada except for a history of excellence in research. “What we’re talking about is a lost decade,” says Jack Corman, President, and Institutional Review Board Services. “So now we’re trying to play catch up.”
Corman says that how Canada proceeds depends on what government wants to accomplish—to rearrange the furniture or to make fundamental change to the clinical trial system in Canada. “Talk is cheap, and it’s not cheap talk. There are millions that have been spent—and I deliberately do not use the term invested—on governments constructing schemes to bring more research [to Canada], to harmonize or centralize ethics reviews in a government run system, and they’ve backfired every time. So maybe this time it’ll work, but I’m not counting on it based on the past record,” says Corman.
Expensive research
Canada is now the most expensive country in the world in which to perform a clinical trial. Although cost is only one of the many factors a company takes into consideration when choosing a clinical trial location, the price to do research in Canada is almost double that of Spain and the United Kingdom. In comparing the per-patient cost for the same trials, Canada is nearly twice as costly as France and Germany.
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