Country Attractiveness for Conducting Clinical Trials – A Literature Review

Purpose: Clinical trials are a big business worldwide, bringing benefits to patients and the healthcare systems of the countries that attract them. However, despite the extremely high scientific interest in clinical research in the medical literature, there is very little economic literature on clinical research and, in particular, on the factors that influence a country's attractiveness for clinical research. The purpose of this paper is to provide a review of this literature and the main approaches and findings used.Approach: For this paper, the WoS CC database was first searched and papers on clinical trials published in 2015 or later were analyzed, with a focus on papers from the research area of business economics and public administration. Subsequently, an overview of the most important published papers on the study of the attractiveness of countries is then provided, and the methodological principles and results of the analyzed papers are explained.Findings: A review of the literature shows that there are few studies investigating the attractiveness of countries for clinical research. Furthermore, the published papers are often small and examine individual cases or small samples of countries. However, the most important factors identified are the speed, reliability and efficiency of the hospital system and the predictability of regulations. The cost of research in each country, although not unimportant, is secondary to the key factors highlighted.Practical Implications: Clinical trials are of great importance for human health. However, they are also important for economic reasons but are underrepresented in the scientific literature dealing with them. This paper provides researchers with a framework for future scientific research. However, as it focuses on the study of the attractiveness of clinical trials, it is also useful for regulators and policy makers to gain a better understanding of this field.Originality/Value: This paper offers an overview of an important but neglected scientific field and, by systematizing and interpreting the research and its results, enables further development and facilitates future research.