As a result of having the largest population, China is a country with the highest number of potential patients. Unfortunately, China’s patient pool remains largely untapped due to several country-specific challenges and obstacles. One of the major issues is the lack of widespread awareness within the general Chinese population regarding the clinical trials. Even the physicians are not fully aware of the clinical trial procedures, therefore they are unable to recommend the trials to patients as a treatment option. Additionally, the commitment to clinical trials of Chinese investigators are not very satisfactory, according to the surveys conducted in China. This poses a recruitment problem because suitable patients may not know how to find relevant information or how to participate in clinical trials. Unlike other countries, it is mandatory for sites in China to meet relatively more requirements before being approved as sites for clinical trials, thereby resultantly the approved sites are extremely low in number. This leads to an issue, wherein the patients live too far away from an approved site to travel for trials regularly. This presents a logistical problem, where patients may not have the means or desire to travel to a distant trial location for frequent treatments. Furthermore, it is expected that China may face oversaturation of studies with the increased number of clinical trials if aforementioned conditions are improved. At present oversaturation is seen only in the developed countries like the US, Japan and Europe. Therefore, simultaneously it is also important to regulate the trials to avoid over-saturation within China. However, China being the world’s third largest market for pharmaceuticals with an expectancy to grow further by approximately 22% annually, additionally with its low cost for clinical trial as compared to any market lucrative countries in the world, makes China the most attractive country worldwide and is expected to remain so for a substantial foreseeable future. This dynamic potential of China is credited to bring increasingly more clinical trial to its soil. Currently, there are around 2,000 Clinical trials from phase-1 to Phase-IV, running full-fledged, but legally awarded only to tier 3A hospitals ranging around 400 hospital facilities (excluding military hospitals).
As previously explained, the aforementioned conditions makes patient recruitment in China relatively challenging out of which, the following are top rated obstacles as per the statistics.
i) Multiple Clinical trial at single site causing infrastructural shortcomings; ii) Recruiting patients living afar from such sites causing logistic problem; iii) Investigator lack of motivation because of their other involvement To overcome above challenges, Patient Recruitment Experts have toiled to achieve the given target significantly by applying strategically holistic approaches. Recruitment strategies in China lies mainly on offline tactics which is more effective than Online tactics. Specifically, Doctors referrals are seen as the most effective strategy, since their recommendation to participate in trials as treatment option is trusted by patients. Site support tools also play a vital role in informing and educating the trial candidates regarding the trial and ultimately recruiting them for trial. Other tactic, which is also an effective tool, is to approach the advocacy group to introduce the patients to the clinical trials. Furthermore, China is a large nation with the highest number of internet as well as mobile users, whereby Online tactics is only the way out to connect to the huge population of potential candidates. For example, a patient specialised website or a widely used application can provide recruitment opportunities, which otherwise remains largely underused.
