By Craig Morgan
Patients can be assured that the medicine they are prescribed has been vetted for safety and efficacy by a long and arduous discovery process guided by governmental regulatory agencies. The central pillar of this rigorous process is the human clinical trial. The success of this model has resulted in a proliferation of clinical trials worldwide. Since the International Committee of Medical Journal Editors (ICJME) established trial registration requirements in 2005, there has been over a tenfold increase in clinical trial registrations globally. However, against this backdrop the European Union (EU) recorded a concerning 25% decrease in clinical trial applications (CTA) from 2007 to 2011, and since 2007 this downward trend in the total number of CTAs and unique trials has continued. Why?