Clinical R&D organizations have placed increasing emphasis over the past decade on finding clinical research subjects in emerging global regions including Asia Pacific, Eastern Europe, and South America. This emphasis has multiple business drivers, but perhaps the most prominent is the ever-increasing competition for subjects.  

 Interestingly, enrollment metrics compiled from the Medidata Insights metrics warehouse—comprising close to 1,700 studies from 50 R&D organizations—tell a somewhat different story. The graph displays the relative proportion of trial subjects recruited annually from each of four global regions, from 2008 through 2011. In particular, the trend in proportion of subjects recruited from Eastern Europe and Asia Pacific appears to be flat or even slightly down over this four-year period, while the trends for North America and Western Europe are flat or even slightly up over the same period. 

North American enrollment rose slightly, while Asian Pacific slightly fell. 

It is not clear to what extent this trend will continue. What do you think the main drivers are? Can it primarily be attributed to the economic slowdown? Have sponsors concluded that conducting studies in these emerging markets is too complicated? Stay tuned as we will definitely keep an eye on this trend to see how it plays out in 2012.  

Each month, an Insights metric to highlight emerging trends in clinical development will be featured. For more on the industry benchmarks and clinical business analytics capabilities of Medidata Insights, please visit 