Looking at data from clinicaltrials.gov, it is clear to see that Israel is the overwhelming 'hub' for clinical trials in the Middle East region. With an ever-growing technology market and a culture that strongly supports entrepreneurial activities, Israel has become a hot bed of activity within the Life Sciences hub with new companies being established on a monthly basis.
With a well trained clinical workforce and modern, well equipped medical centers, Israel is an attractive location for drug development companies. Skilled investigators and technologically able clinical sites mean that a high quality of data is obtained alongside a computerized and sophisticated data management system meaning that this data can be managed effectively and efficiently.
Another key advantage of running trials in this region are the relatively high enrolment and retention rates that are of course very beneficial to trial budgets and timelines. Due to a highly developed data management system across the whole of Israel, data for each patient can be easily tracked. On a more cultural level, there is lot more trust between patients and physicians and also between family physicians and hospital investigators/physicians meaning the right patients can be found more readily and encouraged to participate quickly. In fact, Israel's high patient and recruitment rates has often led to Israeli sites being added to an international study, or targets for these sites being increased to meet overall recruitment needs. Not only is Israel seen as a stand-out country for patient recruitment, but its patient landscape is very diverse which can be a key benefit for clinical trials.
Working in a smaller nation such as Israel has its advantages as it means bureaucratic delays can often be avoided. Although Israeli regulations are being promoted as more simplified and more accessible, the regulatory landscape in this industry is seen as complicated and unclear by companies based in the US and Europe. Companies need to effectively obtain approval from Helsinki Committees and by the Ministry of Health. For sponsor companies based outside of Israel; these can be difficult processes to manage, especially when trying to break into such a tight-knit community like that found in Israel. These companies have to rely heavily on CROs and other partners to provide them with the required regulatory and cultural expertise, knowledge and, importantly, contacts to facilitate a successful trial.
This reliance on strong partnerships with providers is not specific only to companies based outside of Israel, but also the smaller companies within Israel have a heavy reliance on providers. With one main exception, the vast majority of pharma/biotech/medical device companies in Israel are small to mid-sized and are in the earlier stages of clinical trials and therefore rely heavily on the expertise and resources of CROs and other provider companies.
In summary, with the diverse patient landscape and attractive patient enrolment figures, combined with the highly skilled workforce Israel is a growing hotbed for clinical trials and is moving on from being a 'rescue project' for struggling clinical trials to a prime location.