GlobalData’s clinical trials database shows that since 2015, trial activity has steadily increased year-on-year for active control trials, peaking during 2023 trials. In 2020, the number of active control trials dropped, largely due to the impact of the Covid-19 pandemic, which disrupted recruitment, delayed study initiations and redirected resources towards Covid-related clinical trials.

Due to resumed trial activity, trial numbers then climbed again, consistently increasing from 2021 onwards. This was driven by the expansion of drug development programmes and the broader use of adaptive and innovative trial designs. 2025 may seem to have a low percentage, but the year is still ongoing, so figures may change.

Whilst overall trial activity had been gradually increasing, the post-2020 period saw increased year-on-year rises, reflecting increased investment and the prioritisation of high-demand therapeutic areas. Asia-Pacific (APAC) dominated in the total number of active control trials, followed by Europe.

Active control trials are dominant in APAC due to diverse patient populations, lower trial costs and growing pharmaceutical markets. Regulatory agencies increasingly require comparative efficacy data and sponsors conduct sites in these regions for efficient recruitment with lower costs. With increasing expertise and infrastructure in these trials, APAC
can be a more appealing location for sponsors to conduct active control studies.

North America, the Middle East and Africa, and South and Central America remain far behind the leading regions. A total of 42.4% of all APAC studies are conducted in China, where streamlined regulatory processes, government incentives and the rapid growth of domestic pharmaceutical and biotech industries have fuelled a significant rise in active control trials. These trials are often used to benchmark biosimilars and innovative therapies, aligning with global standards and accelerating drug development within the country.

China’s vast, diverse patient population and strong partnerships with global pharma enable faster recruitment and make the country a key hub for large-scale, comparative active control studies. Within APAC, India and South Korea are on the list of the top 5 countries for active control trials. India also has a large patient population, and with cost-effective trial operations, is also a prime location for active control studies.