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Improving Access and Participation in Clinical Trials in Ireland, a Patient-centred Digital Health Platform

Across Europe, we continue to see a declining trend in the number of clinical trials taking place, most notably since the European Union Clinical Trials Directive (CTD) was established in 2004. The decline in clinical trials in Ireland is a major concern, as it means that fewer people are given access to potentially life-saving treatments. This can have long-term effects on the quality of care being provided, as well as making it harder for new treatments to be developed and tested. However, the CTD has long-felt ramifications for European patients. The regulatory burden and insurance requirements grew even more burdensome. At the same time, the global COVID-19 pandemic also affected the number of clinical trials, which decreased by 19.6% in Europe between August and October of 2020 compared to 2019. However, the effects of this decrease in access to clinical trials are being felt more severely in countries like Ireland which have far fewer trials than their peers. In this article, we explore the causes of decreased access to ground-breaking trials in Ireland and how to improve the quality of health care to create a healthier, more efficient system that better serves the Irish population.

The Current Landscape of Research in Europe and Home in Ireland

Despite Ireland’s significant spend on its healthcare system, diverse population, and heavy inbound investment from the pharma and med-tech sectors, Ireland is not able to keep up with its European counterparts in terms of clinical trial participation. According to the Central Statistics Office (CSO) of Ireland, the foreign direct investment (FDI) in Ireland increased by €109 billion to €1,208 billion in 2021, a large proportion of that coming from the pharmaceutical and med-tech sectors. Compared to Finland and Denmark, which both have similar populations and economic wealth, Ireland has only seen 18% of the 2,290 clinical trials conducted between 2013 to 2021 in the three countries. In contrast, Finland and Denmark have respectively seen 29% and 53% of these clinical trials.

Ireland is not alone. The number of clinical trials in the UK has also declined significantly in recent times, with the Association of British Pharmaceutical Industry reporting that the number of industry-backed clinical trials started in the UK each year fell by 41% between 2017 and 2021. This steep drop is due largely to a combination of factors, including slow set-up times, increased staff fatigue and turnover, and a reduction in the NHS’s research capacity. Unfortunately, this means that UK and Ireland are lagging behind many of their European counterparts in attracting clinical trials.

The main barrier for Ireland when it comes to clinical trials is the need for more resources, both in terms of funds and personnel. Clinical trials require a significant amount of time from both researchers and practitioners to be successful. However, due to budgetary constraints, they are often forced to make do with limited personnel or wait for additional funding. Additionally, the infrastructure needed to support clinical trials is often expensive and difficult to obtain.