TrialScout

Washington, D.C.

America’s Capital is Not Its Leader in Clinical Trial Industry

Written by Jack Beecher, TrialScout Data Analyst

“The Clinical Trials Landscape is an information set derived from the proprietary database transformation that sits behind www.TrialScout.com,” said Dr. Irfan Khan, CEO of Circuit Clinical. “Our objective with this project is to provide novel insights to patients, providers, and healthcare administrators, in hopes of helping them understand clinical research as a care option and inform choices in regards to it.”

According to Craig Lipset, the former Head of Clinical Innovation at Pfizer and current board member of Empirican Group Inc. (which owns Circuit Clinical), "Pharmaceutical researchers rely on tremendous amounts of data to select locations for multi-center clinical trials. TrialScout’s Clinical Trials Landscape provides new information for study planners to improve decision-making and accelerate the development of new medicines." For Washington D.C., although a substantial amount of clinical trials has been and is being conducted in the area, it does not compare favorably to several similar and smaller markets. Within the capital region, Johns Hopkins stands above the others in the clinical trial industry, but this is not to say that there is a dearth of options.

Despite being the fourth-most populous Combined Statistical Area (CSA) and being ranked as the seventh-largest Designated Market Area (DMA) in the nation, its capital ranks ninth in clinical trial output1,3,4. According to the TrialScout database, 20,087 trials have been conducted in the Washington D.C. CSA (which also includes the greater Baltimore area as well as parts of eastern Virginia)1; while it has outperformed some similarly-ranked DMAs such as Dallas (ranked as the fifth-largest DMA by Nielsen in 2017, and has 14,309 trials) and Houston (ranked as the eighth-largest DMA, and 17,431 trials), it still trails behind others1,3. The Boston CSA has conducted 26,732 trials despite being ranked ninth by Nielsen, and the San Jose-San Francisco CSA has conducted slightly more (20,934) than D.C. while being ranked one DMA spot ahead1,3.

Distribution of Clinical Trials per Zip Code1

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Population estimates further reinforce the notion that D.C. trails similar markets in the clinical trial industry. The D.C. CSA has a population of 9,765,772; again, it is important to note that this includes the greater Baltimore area as well5. Still, the fact that D.C. has roughly 2,500 more trials than the Houston CSA is in spite of having a population more than four million greater than Houston’s (5,641,077). In addition, the San Jose CSA has conducted slightly more trials than D.C. despite a population roughly 900,000 fewer (8,837,789), and Boston has conducted significantly more trials with a population about 1.5 million fewer than D.C. (8,233,270)1,5. A similar amount of trials to D.C. have also been conducted in the Detroit CSA (20,877), despite it having a population even smaller than Houston’s (5,336,286) as well as a lower DMA rank (13th) than the capital region1,3,5.

Clinical Trials in Washington-Baltimore-Northern Virginia CSA (2018)1

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10 Years of the Top 5 Clinical Trial Hospitals in Washington-Baltimore-Northern Virginia CSA (2018)1

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The health system that conducts the most clinical trials in the greater D.C. area is the Johns Hopkins Health System, which had 1,600 active* trials in 2018; this was nearly double the output of the National Institutes of Health (NIH), which was the second-most active system in this department with a total of 857 active trials last year. At a top level, Johns Hopkins accounted for more than a quarter (25.7%) of active clinical trials in the CSA, while the NIH accounted for 13.8%. Following these two systems for last year’s totals are MedStar Health (745 active trials, 12% of D.C.’s total), the University of Maryland Medical System (644 active trials, 10.4% of D.C.’s total), and Children’s National Health System (278 active trials, 4.5% of D.C.’s total). Beyond these, an additional five health systems in the CSA had at least 100 active clinical trials in 2018; these include Inova Health System (218 active trials), Universal Health Services (138 active trials), the Walter Reed National Military Medical Center (133 active trials), Virginia Cancer Specialists (132 active trials) and LifeBridge Health (122 active trials)1.

Despite Johns Hopkins being the most active health system in the area, the most active individual location in the CSA last year was actually the NIH Clinical Center, with 762 active clinical trials, accounting for 12.3% of the CSA’s total last year alone. Not far behind, however, is the Johns Hopkins Hospital, with 682 active trials last year (11% of active trials in the area). The top five individual clinical trial locations in the capital region are rounded out by the University of Maryland Medical Center (567 active trials), the Sidney Kimmel Cancer Center at Johns Hopkins Hospital (368 active trials), and MedStar Georgetown University Hospital (348 active trials). Additionally, seven other locations in the CSA had at least 100 active trials last year: the Children’s National Main Hospital (278 active trials), MedStar Washington Hospital Center (213 active trials), Inova Fairfax Hospital (169 active trials), Johns Hopkins Bayview Medical Center (157 active trials), George Washington University Hospital (138 active trials), Walter Reed National Military Medical Center (123 active trials), and Virginia Cancer Specialists’ Fairfax location (121 active trials)1.

Overall, the Washington D.C. CSA has seen steady growth in trial volume over the past decade, growing from totals of 4,267 active trials in 2008 to 6,219 in 2018. Additionally, D.C.’s output in the clinical trial industry has increased every year over this span, except from 2017 to 2018. So, while the CSA has seen notable growth, it is not as demonstrated as that of other cities in a relative sense; several of the cities documented in this series have seen their outputs double over the past decade, whereas D.C. has increased by about 50%. Still, however, several locations in the D.C. area have seen significant growth over the last ten years, in turn driving the growth of the entire area. Most notably, the Johns Hopkins Hospital has more than doubled from totals of 321 active trials in 2008 to its 2018 total of 682, and MedStar Georgetown University Hospital has nearly tripled from 130 active trials in 2008 to 348 last year. In addition, the University of Maryland Medical Center has increased from 393 active trials in 2008 to 567 in 2018, the Sidney Kimmel Cancer Center from 260 in 2008 to 368 in 2018, Children’s National from 180 in 2008 to 278 in 2018, and MedStar Washington Hospital Center from 118 active trials to 213 in 2018. In other notable instances of growth, Inova Fairfax Hospital has nearly doubled from 86 active trials in 2008 to 169 last year, the Walter Reed National Military Medical Center has more than doubled from 51 active trials in 2008 to 123 in 2018, and the Mercy Medical Center in Baltimore has jumped from 13 active trials in 2008 to 80 last year1.

Alternative Clinical Centers in Washington-Baltimore-Northern Virginia CSA (2018)1

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A fair portion of the alternative clinical trial sites in the Washington D.C. CSA has also seen notable growth over the past decade as they look to make their mark on its landscape. The most active of this type of location in the capital region last year was the aforementioned Virginia Cancer Specialists location, which has grown from three active trials in 2008 to its 2018 total of 121. The next-most active of these sites in the area is the Center for Cancer and Blood Disorders in Bethesda, with 56 active trials last year (though its growth is insignificant). Following this is Capital Digestive Care in Chevy Chase (with about 51 active trials last year, growing from 14 in 2008), the Kennedy Krieger Institute (38 active trials in 2018, from nine in 2008) and Shenandoah Oncology (33 active trials last year, from a single one in 2009) to round out the top five. Other alternative sites in D.C. that have grown relatively significantly over this period include Maryland Oncology Hematology at the Aquilino Cancer Center (ten active trials in 2008, 32 in 2018), Digestive Disease Associates in Catonsville (27 active trials in 2018, from a single one in 2011), and Pharmasite Research (five active trials in 2008, 21 in 2018) among others1.

Current Active Clinical Trials in Washington-Baltimore-Northern Virginia CSA2

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The TrialScout team has conducted additional analyses of the site’s database to provide a current look at where the options for clinical research as a care option reside in the capital region. According to these analyses, there are 7,923 clinical trials in the Washington D.C. CSA that are currently active, and 4,463 (or, 56.3%) of these are recruiting for participation. The Johns Hopkins Health System leads the way among D.C. health systems in currently active trials as well, with 1,746 (1,009, or 57.8%, of which are recruiting), accounting for 22% of active trials in the D.C. CSA and 22.6% of its recruiting trials.

Johns Hopkins is followed by the NIH, which has a current total of 1,124 active trials in the CSA (869, or 77.3%, of which are recruiting), and accounts for 14.2% and 19.5% of active and recruiting trials in the area, respectively. In line with being the most active clinical trial location in the CSA in 2018, the NIH Clinical Center also has the most currently active and recruiting trials among individual locations in D.C., with 1,010 and 809, respectively. The Clinical Center alone accounts for 89.9% of the NIH’s active trials and 93.1% of the NIH’s active and recruiting trials in D.C., as well as 12.7% of active trials and 18.1% of recruiting trials in the entire CSA. MedStar Health is not far behind, with 922 currently active clinical trials in the region (445, or 48.3%, of which are recruiting), comprising 11.6% of currently active clinical trials in the CSA as well as 10% of its recruiting trials. The next-most active health system in the area is the University of Maryland Medical System, with 749 active trials (412, or 55%, of them recruiting), comprising 9.5% of the CSA’s active trials and 9.2% of its recruiting trials. Finally, Children’s National Health System has 322 active trials at the moment (215, or 66.8%, of them recruiting), making up 4.1% of D.C.’s active clinical trials and 4.8% of its recruiting trials2.

While the capital region is performing well in the clinical trial industry and is the first CSA in this series to crack the 20,000-trial mark, this is overshadowed by its massive population. Chicago, a very similarly-populated market, outpaces D.C. in clinical trials significantly, and several cities with much smaller populations have trial volumes that are either comparable to or more impressive than D.C.’s1,5. Still, however, with Johns Hopkins and the NIH around, Washington D.C. should never be hurting for clinical trials, evidenced by its growth1.

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)

  1. Approximate attributable data as per the TrialScout database collapse as of 4/11/2019. All data is derived from https://clinicaltrials.gov/
  2. Approximate attributable data as per the TrialScout database collapse as of 7/22/2019. All data is derived from https://clinicaltrials.gov/
  3. Lyons Public Relations Broadcast PR Solutions. (2017). 2017 Nielsen DMA rankings – Full list. Retrieved from https://www.lyonspr.com/latest-nielsen-dma-rankings/
  4. U.S. Census Bureau. (2018) New Census Bureau population estimates show Dallas-Fort Worth-Arlington has the largest growth in the United States. Retrieved from https://www.census.gov/newsroom/press-releases/2018/popest-metro-county.html
  5. U.S. Census Bureau, Population Division. (2019). Annual estimates of the resident population: April 1, 2010 to July 1, 2018 – United States – Combined statistical area; and for Puerto Rico. Retrieved from https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk

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