Did relaxing clinical trial regulation enhance the stock of scientific knowledge in India? Not necessarily.

Abstract

The increasing amount of clinical research conducted outside the "traditional" countries raises questions about the benefits of hosting offshored clinical research. The extent to which trials contribute to the scientific knowledge base and, in particular, whether there are differences between different types of trials remain open questions. By examining a change in clinical trial regulations in India, a country often viewed as a first-choice offshoring location, we study how the relaxation of clinical trial regulations affects the number and the type of clinical trials as well as the domestic scientific knowledge base. Based on trial data from ClinicalTrials.gov and data on associated publication activities, our empirical analysis suggests that, despite an initial increase in the number of clinical trials, relaxing clinical trial regulations has a limited impact on the domestic scientific knowledge base. More specifically, the number of Indian researchers involved in the production of trial-related scientific knowledge remains modest. Furthermore, the potential to learn from the additional trials appears to be limited: the influx of phase 3 trials-mainly sponsored by Western-pharmaceutical firms-is accompanied by a lower likelihood that the trial results will be used in Indian researchers' subsequent research activities when compared to phase 3 trials with preceding phase 2 trials, as was required before the regulatory change. Overall, our results contradict expectations that relaxing the regulatory requirements for conducting late-stage clinical trials is an appropriate means of supporting the development of the domestic scientific knowledge base.