Novartis runs 40% of its trials outside the US now.

Novartis runs 40% of its trials outside the US now. AstraZeneca expanded to 200+ sites across Asia in 2025. The West is saturated. APAC is where enrollment happens. 𝗧𝗵𝗲 𝘀𝗵𝗶𝗳𝘁: → US trial enrollment dropped 12% since 2022 → APAC enrollment grew 28% in same period → China: 6,000+ active trials → India: 4,500+ active trials → Japan, Korea, Australia: 3,000+ combined Pfizer, Roche, and Merck all increased APAC site investments. 𝗪𝗵𝘆 𝗔𝗣𝗔𝗖 𝘄𝗼𝗿𝗸𝘀: → Treatment-naive patient populations → 40-60% lower costs than US/EU → Faster enrollment timelines (2x in some indications) → Regulatory reforms in India and China → Growing CRO infrastructure (IQVIA, PPD, Parexel expanding) 𝗧𝗵𝗲 𝗰𝗵𝗮𝗹𝗹𝗲𝗻𝗴𝗲: → No unified investigator registries across APAC → Site capabilities vary dramatically by country → Enrollment history data is fragmented → US data vendors have minimal APAC coverage → Language and regulatory differences by market 𝗧𝗵𝗲 𝗳𝗶𝘅: → Map investigators by country and therapeutic area → Prioritize sites with global CRO relationships → Verify enrollment history, not just credentials → Build country-specific site networks → Track regulatory approval timelines by market

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