“The Clinical Trials Landscape is information we want to share with the public that is derived from the proprietary database transformation underlying www.TrialScout.com,” said Dr. Irfan Khan, CEO of Circuit Clinical. “Our goal with these pieces is to equip patients, providers, and healthcare administrators with new insights that will help them understand clinical research as a care option and inform choices pertaining to it.” Craig Lipset, the former Head of Clinical Innovation for Pfizer and a current board member of Empirican Group Inc. (which owns Circuit Clinical), adds "Researchers in the pharmaceutical industry rely on great amounts of data for selecting the locations where clinical trials will be conducted at. TrialScout’s™ Clinical Trial Landscape Series provides new information that improve the decision-making process for study planners and in turn accelerate the development of new medicines." As the largest metropolitan area in the country with status as a lynchpin of academia and research, it is no surprise that New York City leads the way in the U.S. clinical trial industry, but deeper analyses indicate that size is not everything.
In line with the size of its metropolitan area as well as being generally viewed as one of the biggest hubs for research in the country, New York City is absolutely unrivaled for clinical trials in terms of sheer output. A total of 54,396 clinical trials have been conducted in the New York Combined Statistical Area (CSA), roughly 10,000 more than the city with the second-highest total (Los Angeles)1,2. As you can see from the map below, the New York City CSA encompasses a massive area, including downstate New York, the entirety of Long Island, western Connecticut, northern New Jersey, and parts of eastern Pennsylvania. It should thus come as no surprise that New York was ranked by Nielsen as the largest Designated Market Area (DMA) in the country, and similarly-ranked markets do not come close to New York’s total (Los Angeles, ranked second by Nielsen, has 43,226 trials whereas Chicago, ranked third, has 24,610)1,2,4.
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Similarly to comparisons based on trial volume, New York City of course towers above all other U.S. cities in population, with a total of 23,876,155 residents; the Los Angeles CSA, ranking second in the country in this department as well, has about five million fewer residents (18,764,814)6. However, despite having both a high trial volume and population in a vacuum, several other cities are performing better in the clinical trial industry when trial volume is viewed in the context of the population being served. In other words, other cities have more trials conducted per person than New York does; in fact, of the 21 cities discussed in the Clinical Trials Landscape, New York ranks 17th in this department:
|CSA||Number of Trials1||Population5||Number of Trials per 1000 Residents|
|St. Louis CSA||2,911,823||12,651||4.3|
|San Diego MSA||3,140,069||9,799||3.1|
|San Jose CSA||8,837,789||20,934||2.4|
|Los Angeles CSA||18,764,814||43,226||2.3|
|New York CSA||23,876,155||54,396||2.3|
|Washington DC CSA||9,765,772||20,087||2.1|
Each market above New York City in this chart has conducted more trials per person, while each below has conducted less. So, despite its extremely high trial volume, New York is performing about in line with cities such as Los Angeles, Atlanta, and San Jose when population is taken into account.
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The most active health system in the New York City CSA for clinical trials last year was Memorial Sloan Kettering Cancer Center, with 2,749 active* trials (17.7% of New York’s 2018 total). This is followed by the NewYork-Presbyterian Healthcare System (2,023 active trials in 2018, 13% of New York’s total), NYU Langone Health (1,097 active trials last year, 7.1% of all in New York), Mount Sinai Health System (1,072 active trials last year, 6.9% of all in New York), and Montefiore Health System (738 active trials in 2018, 4.8% of New York City’s total). Clinical trials are conducted throughout a wide variety of health systems in the greater New York area, however, as the aforementioned five systems accounted for about half of the active trials in the CSA in 2018. An additional 16 health systems in the New York CSA had at least 100 active trials last year as seen below (the aforementioned top five are included for reference)1:
|Health System||Number of Active Trials (2018)|
|Memorial Sloan Kettering Cancer Center||2,749|
|NewYork-Presbyterian Healthcare System||2,023|
|NYU Langone Health||1,097|
|MountSinai Health System||1,072|
|Montefiore Health System||738|
|Hackensack Meridian Health||586|
|Yale New Haven Health System||523|
|RWJ Barnabas Health||357|
|Lehigh Valley Health Network||279|
|U.S. Department of Veterans Affairs||234|
|Stony Brook University Medical Center||227|
|Atlantic Health System||218|
|New York City Health and Hospitals Corp.||161|
|Saint Lukes Hospital and Health Network||146|
|Hospital for Special Surgery||141|
|Valley Health System (New Jersey)||115|
|New York State Government||112|
|University Hospital Newark||109|
The flagship Memorial Sloan Kettering Cancer Center was the most active individual location in the greater New York City area, with 1,280 active trials last year; the total of this location alone comprises 46.6% of Memorial Sloan Kettering’s active trials and 8.3% of all active trials in the CSA. In a similar vein to their parent health systems, NewYork-Presbyterian Columbia University Irving Medical Center is not too far behind Memorial Sloan Kettering, with 1,103 active trials last year, accounting for 54.5% of NewYork-Presbyterian’s active trials as well as 7.1% of the entire CSA’s alone. The top five in New York City is rounded out by The Mount Sinai Hospital(803 active trials), NewYork-Presbyterian Weill Cornell Medical Center (690 active trials), and Montefiore Hospital’s Moses Campus (413 active trials). To further accentuate the depth seen in New York City’s clinical trial industry, 29 individual locations beyond the five aforementioned had at least 100 active clinical trials last year; among the most active of these are the NYU School of Medicine (353 active trials), Yale University(308 active trials), the Yale School of Medicine (303 active trials), Hackensack University Medical Center (297 active trials), and the Memorial Sloan Kettering Cancer Center in Commack (293 active trials). Remarkably, a total of 83 individual locations in the CSA had 30 or more active trials last year1.
The New York CSA has seen a great deal of growth in its clinical trial output over the past decade, going from totals of 8,561 active trials in 2008 to 15,506 in 2018. The most significant contributions to this growth are seen among the top historical performers in the area; for instance, Memorial Sloan Kettering Cancer Center’s active trial output increased by 821 from 2008 to 2018 (459 active trials in 2008 to its 2018 total of 1,280), and NewYork-Presbyterian Columbia University Irving Medical Center’s increased by 514 over the same period of time (589 active trials in 2008 to 1,103 in 2018). The next tier of locations with significant growth includes The Mount Sinai Hospital (growing 452 active trials, from 351 in 2008 to 803 in 2018), NewYork-Presbyterian Weill Cornell Medical Center (growing 361 active trials, from 329 in 2008 to 690 last year), and Memorial Sloan Kettering Cancer Center in Westchester (growth of 269 active trials, from 12 in 2008 to 269 in 2018). For a top-level look at this growth, 18 individual locations in the greater New York City area had active trial outputs in 2018 that were at least 100 greater than their 2008 outputs, and this total grows to 42 when the cutoff is extended to 301.
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Like all cities covered in the Clinical Trials Landscape Series, New York has alternative clinical trial sites outside of large health systems that are looking to make their mark on the industry. The most active of these sites in New York last year was New York Cancer and Blood Specialists’ Setauket Medical Oncology location with 47 active trials (and growing from seven in 2008). Right behind this site is Premier Medical Group in Poughkeepsie, with 46 active trials last year (up from 14 in 2008). The top five in New York is then rounded out by Clinical Research Alliance in Lake Success (32 active trials in 2018, from seven in 2008), Manhattan Medical Research (30 active trials in 2018, from one in 2009), and Concorde Medical Group (29 active trials last year, from three in 2008). Beyond the top five, other notable alternative sites in the greater New York area include the New England Institute for Clinical Research (28 active trials last year, up from four in 2012), the Kessler Foundation in West Orange, New Jersey (28 active trials last year, from seven in 2008), Gastroenterology Center of Connecticut at the Spring Glen Medical Center (27 active trials last year, from three in 2008), and Richmond Behavioral Associates (24 active trials last year, from nine in 2008) among others1.
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A total of 18,269 active clinical trials are currently being conducted in the New York CSA, according to more recent analyses of the TrialScout database. Of these, 9,868 (54%) are currently recruiting for participation. Memorial Sloan Kettering is still the most active health system for clinical trials in the area and only appears to be widening its lead; with 3,270 currently active trials and 1,900 (58.1%) of them recruiting, this system accounts for 17.9% of the CSA’s active trials as well as 19.3% of its recruiting trials. In addition, Memorial Sloan Kettering currently stands second among health systems in the entire country in both active and recruiting trials; it only trails Kaiser Permanente, which spans the entire state of California and extends into neighboring states as well. The flagship location of Memorial Sloan Kettering is still the most active individual location in the New York City CSA, with 1,320 active trials (670, or 50.8%, of which are recruiting). This site alone accounts for 40.4% of Memorial Sloan Kettering’s currently active trials and 35.3% of its recruiting trials, as well as 7.2% and 6.8% of the CSA’s active and recruiting trials, respectively. The NewYork-Presbyterian Healthcare System currently has 2,095 active clinical trials, with 1,232 (64.8%) of them recruiting. This system accounts for 11.5% of active clinical trials in New York City as well as 12.5% of its recruiting trials. An interesting finding that comes out of this is that even though the NewYork-Presbyterian Columbia University Irving Medical Center, as the second-most active individual location in the CSA with 1,033 currently active trials, trails the most active by about 300, it only has 60 fewer recruiting trials (610 versus Memorial Sloan Kettering’s 670). NYU Langone Health is currently the third-most active health system for clinical trials in the New York CSA, with 1,207 active trials (688, or 57%, of which are recruiting); this system accounts for 6.6% of New York City’s active trials as well as 7% of is recruiting trials. Not far behind NYU Langone Health is the Mount Sinai Health System, which boasts 1,092 active trials (598, or 54.8%, of which are recruiting), and comprises 6% of New York City’s active trials in addition to 6.1% of the city’s recruiting trials. Finally, the fifth-most active health system in the New York CSA for clinical trials is the Montefiore Health System, which currently boasts 914 active trials (498, or 54.5%, of which are recruiting), and accounts for 5% of both New York City’s active and recruiting trials2.
As the final entry in TrialScout’s Clinical Trials Landscape Series, the greater New York City area has the greatest concentration of clinical trials in the country. While other cities may be performing better relative to their populations, it cannot be denied that the sheer volume held by New York City makes it the central hub of the country for clinical trials, and this will likely never change.
To follow the clinical trial landscape series, visit the TrialScout Clinical Trials Landscape
*Active in 2018 = Active at any point in 2018 (Start date of study is before 12/31/2018 and end date is after 1/1/2018)