As of November 2019, the National Library of Medicine (NLM) reported nearly 16,000 active clinical trials in the U.S. alone—not including the almost 2,000 trials completed in the past year. In fact, 2019 has seen the greatest total number of reported studies since the NLM began tracking clinical trial data almost 20 years ago.
While clinical trials are FDA-mandated for all new treatments—including drugs, medical devices, vaccines, and gene therapies—these studies also produce crucial data used in making other care decisions. In addition to evaluating the safety and effectiveness of new treatment options, clinical trials can help both providers and manufacturers determine which medical approaches work best for certain illnesses or patient populations.
Clinical studies are classified into two main groups based on the research protocol and whether or not participants receive medical interventions as part of their testing. These categories are defined as:
Interventional studies (more commonly referred to as clinical trials) Investigators assess participant health outcomes based on specific interventions administered as part of the research protocol in order to test the safety and effectiveness of a candidate drug, therapy, or experimental treatment
Observational studies Investigators assess participant health outcomes as established in the research protocol without administering interventions or procedures
Within this framework, clinical studies can be further segmented by subtype—including prevention, treatment, diagnostic, screening, genetic, epidemiological, or quality of life trials.
Definitive Healthcare tracks both interventional and observational trials across fourteen different therapy areas. In this blog, we’ve compiled a list of the top ten most common clinical trials by therapy area.
Cancers have the highest clinical trial volume
With a projected U.S. market value of $100 billion by 2022—and, not to mention, 30 FDA approvals for new chemotherapeutic drugs or drug combinations already this year—it’s no surprise that cancer drugs are among the most highly-tested therapies in clinical trials across the nation.
Total Number of Clinical Trials*
Cardiovascular & Circulatory Diseases
Nervous System Diseases
Endocrinology & Metabolic Diseases
Mental Health & Behavioral Disorders
Fig 1 Data is aggregated using individual hospital clinical trial metrics available on Definitive Healthcare’s Hospitals & IDNs database. Clinical trials information is reported by the U.S. National Library of Medicine. *Note: “total number of clinical trials” is a historic metric that reflects the total number of clinical trials reported to the U.S. National Library of Medicine since they began collecting clinical trial information in 2000 and represents the most recent data available.
A total of 361,628 cancer-related clinical trials have been reported in the past 20 years. With an increasing number of new cancer drugs developed each year, this clinical trial volume is due to grow at an unprecedented rate.
Cardiovascular & circulatory diseases are a leading cause of death in the United States and, because of this, these therapies are the second most highly-tested in clinical trials across the nation—with a total of 62,115 studies conducted in the past 20 years.
Infectious diseases, digestive diseases, and musculoskeletal diseases are also among those therapy areas with the highest total volumes of clinical trials.
Clinical trial volume by state
Fig 2 Sourced from the National Library of Medicine at clinicaltrials.gov. Map represents the 15,861 active clinical trials—including those identified as “recruiting,” “not yet recruiting,” “active,” “not recruiting,” and “enrolling by invitation”—by state from 01/01/2018 to 11/25/2019.
As expected, population density is a significant contributing factor in the geographic distribution of clinical trials across the U.S. Greater patient volumes, after all, increase the likelihood of finding eligible participants for clinical research. For this reason, we see a strong correlation between those states with the largest populations and the highest reported clinical trial volumes—including California, Texas, New York, Florida, and Pennsylvania.
Though it’s not explicitly represented on the above map, there also appears to be a strong correlation between high clinical trial volumes and facility types—where states with high-performing cancer research centers, university medical hospitals, or other research facilities report greater volumes of clinical trials than areas with fewer numbers of these facility types.
Massachusetts, for instance, boasts the highest clinical trial volumes in New England despite its size. However, this state is home to some of the foremost research facilities in the U.S.—including Massachusetts General Hospital, Brigham and Women’s Hospital, Beth Israel Deaconess Medical Center, and the Dana Farber Cancer Institute.
Top hospitals by clinical trial volume
Total # of Clinical Trials*
University of Texas MD Anderson Cancer Center
Massachusetts General Hospital
Memorial Sloan Kettering Cancer Center
Duke University Hospital
National Institutes of Health Clinical Center
Dana Farber Cancer Institute
Vanderbilt University Medical Center
New York-Presbyterian/Columbia University Irving Medical Center
The Johns Hopkins Hospital
Beth Israel Deaconess Medical Center
Fig 3 Data is from Definitive Healthcare’s Hospitals & IDNs database, using clinical trials information reported by the U.S. National Library of Medicine. *Note: “total number of clinical trials” is a historic metric that reflects the total number of clinical trials reported to the U.S. National Library of Medicine since they began collecting clinical trial information in 2000 and represents the most recent data available.
Clinical studies can be sponsored by a number of different agencies ranging from industry organizations like pharmaceutical companies, academic medical centers, or federal agencies—including the National Institutes of Health, the U.S. Department of Defense, and the U.S. Department of Veterans Affairs.
While clinical studies can be conducted in a variety of different locations, access to specific equipment, physician expertise, or sample patient populations quite often influences this decision. With greater access to these critical resources, places like cancer research facilities and university medical centers are frequently selected as locations for hosting clinical trial research.
In fact, all ten of the top hospitals by historic clinical trial volume are cancer research centers, university hospitals, or another type of dedicated research facility—according to Definitive Healthcare data.
Interested in learning more about clinical trials data, and how you can leverage existing intelligence to target areas for new clinical studies? Definitive Healthcare tracks clinical trial metrics for nearly 4,000 participating hospitals and health systems, and 39,000 participating physicians across the U.S. Start a free trial today to see how you can:
Access the most essential clinical trials data—fully integrated with proprietary intelligence on hospitals and physicians
Gain insights on clinical trial participation by hospital, IDN, physician, and physician group
Find qualified physicians in your target geographic or therapy area
Identify facilities in your region with an eligible patient population