Country attractiveness for conducting clinical trials – a literature review

Geršić, Tomislav (author), Vretenar, Nenad (author), Jardas Antonić, Jelena (author)

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.

• Language: English
• Keywords: clinical trials, country attractiveness, factors, costs, regulation
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: FU - Faculty of Administration
• Publication status: Published
• Publication version: Version of Record
• Year: 2025
• Number of pages: Str. 93-117
• Numbering: Vol. 23, no. 2
• PID: 20.500.12556/RUL-176861
• UDC: 339.9:614.212:001.814:001.891
• ISSN on article: 2591-2240
• DOI: 10.17573/cepar.2025.2.04
• COBISS.SI-ID: 257914883
• Publication date in RUL: 11.12.2025

Record is a part of a journal

• Title: Central European public administration review
• Shortened title: CEPAR
• Publisher: Fakulteta za upravo
• ISSN: 2591-2240
• COBISS.SI-ID: 293849600

Licences

• License: CC BY-SA 4.0, Creative Commons Attribution-ShareAlike 4.0 International
• Link: http://creativecommons.org/licenses/by-sa/4.0/
• Description: This Creative Commons license is very similar to the regular Attribution license, but requires the release of all derivative works under this same license.

Secondary language

• Language: Slovenian
• Title: Privlačnost držav za izvajanje kliničnih raziskav – pregled literature

Abstract

Namen: klinične raziskave so velik posel po vsem svetu, saj prinašajo koristi pacientom in zdravstvenim sistemom držav, ki jih pritegnejo. Kljub izjemno velikemu znanstvenemu interesu za klinične raziskave v medicinski literaturi pa je ekonomske literature o kliničnih raziskavah, zlasti o dejavnikih, ki vplivajo na privlačnost države za klinične raziskave, zelo malo. Namen tega članka je podati pregled te literature ter glavnih pristopov in ugotovitev. Pristop: najprej je bila preiskana baza podatkov WoS CC, analizirani pa so bili članki o kliničnih raziskavah, objavljeni leta 2015 ali pozneje, s poudarkom na delih iz raziskovalnih področij poslovne ekonomije in javne uprave. Nato je podan pregled najpomembnejših objavljenih člankov o preučevanju privlačnosti držav, pojasnjena pa so tudi metodološka izhodišča in rezultati analiziranih del. Ugotovitve: pregled literature kaže, da je malo študij, ki bi preučevale privlačnost držav za klinične raziskave. Poleg tega objavljeni članki pogosto niso obsežni in obravnavajo posamezne primere ali majhne vzorce držav. Kljub temu so kot najpomembnejši dejavniki prepoznani hitrost, zaneslji-vost in učinkovitost bolnišničnega sistema ter predvidljivost predpisov. Stroški raziskav v posamezni državi – čeprav niso nepomembni – imajo sekundarno vlogo v primerjavi s poudarjenimi ključnimi dejavniki. Praktične implikacije: klinične raziskave so zelo pomembne za zdravje ljudi. Pomembne so tudi z ekonomskega vidika, vendar so v znanstveni literaturi, ki jih proučuje, podzastopana. Ta članek raziskovalcem nudi okvir za nadaljnje znanstveno raziskovanje. Ker se osredotoča na preučevanje privlačnosti kliničnih raziskav, je koristen tudi za regulatorje in oblikovalce politik pri boljšem razumevanju tega področja. Izvirnost/vrednost: članek ponuja pregled pomembnega, vendar zapostavljenega znanstvenega področja ter z njegovo sistematizacijo in interpretacijo raziskav ter rezultatov omogoča nadaljnji razvoj in olajša prihodnje raziskave.

• Keywords: klinične raziskave, privlačnost držav, dejavniki, stroški, regulativa

Projects

• Funder: Other - Other funder or multiple funders
• Project number: ZIP-UNIRI-2023-14