Depression is moving up the clinical development agenda, but Phase II terminations are putting clinical development productivity in jeopardy

Date: 07. 10. 2023

Recently, we released the results of our global analysis of all clinical trials taking place in 2023 so far. Our review of 13,490 recruiting trial records revealed a changing landscape in clinical development investment. As with previous years, oncology remains a well-studied disease area, with three of the top five most-studied diseases falling within this group, but we also see depression enter the top five for the first time. So far this year, solid tumours has been the most studied disease, followed by breast cancer, stroke and depression, with prostate cancer taking the fifth spot.

Innovation in research for depression

The major uptick in investment into depression should come as no surprise given that an estimated 5% of adults are affected by depression around the world. What’s more, the last major class of antidepressant launched was SSRIs, which was over forty years ago. To bridge this gap, clinical development leaders have started to explore new avenues to treat the disease, with many alternative therapies now – including psychedelics – under investigation.

Phase II attrition at an all-time high

At the end of last year, our 2022 analysis revealed a worrying increase in trial cancellations during Phase II, and this has showed no sign of slowing down. So far in 2023, almost a third (31%) of trials have been cancelled at Phase II, which is a 55% increase on pre-Covid-19 levels. Such high numbers of cancellations will increase the cost of clinical development, slow the rate that new therapies reach market, and potentially prevent viable new treatments from ever reaching patients. Moreover, it’s likely there will be around two more years of high levels of Phase II attrition before the clinical development industry returns to complete normal.

Improving productivity with data

To avoid disruption and the impact of costly cancellations, sponsors must take a data-led approach.  With Phesi Trial Accelerator, sponsors can use the insights held within the world’s largest clinical trial database to simulate clinical trials and make informed choices about protocol design. By leveraging AI and predictive analytics for protocol design, the clinical development industry can overcome the recruiting challenges which have long plagued the industry, select better sites and eliminate avoidable protocol amendments, overall improving productivity and bringing down attrition rates.

Download the report to discover the full findings of our latest global analysis here:


Figure 1: The top five most studied disease indications in the first six months of 2023
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