Best & Worst States for Clinical Trial Access 2024 | Stacker
Access to cutting-edge medical treatments is unevenly distributed across the United States, with patients in some states significantly more likely to be able to participate in clinical trials than those in others. A recent analysis by Kivoa, a document and process management platform for the pharmaceutical industry, reveals a stark geographic disparity in clinical trial accessibility, highlighting the impact of location on a patient’s ability to receive potentially life-saving care.
The analysis, which focused on trials currently open and seeking participants, normalized trial volume per one million residents to allow for fair comparison across states. Data was sourced from ClinicalTrials.gov, the National Institutes of Health’s public registry of clinical studies. The resulting “access score” reflects both the volume of active trials and the density of trials per capita.
Massachusetts leads the nation with an access score of 1,249.2, driven by the presence of leading medical research institutions like Massachusetts General Hospital, Dana-Farber Cancer Institute, and Brigham and Women’s Hospital. California (1,188.8) and New York (1,158.9) followed closely behind, benefiting from high overall trial volume. Maryland (997.2), Pennsylvania (955.3), Texas (813.3), Illinois (796.0), Connecticut (790.3), Ohio (748.7), and North Carolina (727.1) rounded out the top ten.
Even as California boasts the second-highest total number of active trials (2,160), its large population results in a lower per-capita rate, ranking it 47th nationally. Texas, with 1,390 active trials, ranks sixth overall but 49th in per-capita access. This illustrates a key point: raw trial count doesn’t necessarily equate to accessibility.
The states with the lowest access scores are concentrated in the South, and West. Mississippi (348), Arkansas (457.1), Kansas (445.9), Hawai’i (433.4), New Mexico (431.1), Montana (421.8), Oklahoma (417.0), Alaska (412.6), Idaho (378.3), and Wyoming (360.5) all lag significantly behind the national average. Mississippi, with only 142 active trials and a population of nearly three million, has the lowest access score.
The analysis also examined the types of conditions being studied in clinical trials. Oncology trials account for more than a third of all actively recruiting studies, largely due to funding from the National Cancer Institute and the network of NCI-designated cancer centers. Heart disease, neurological conditions, and rare diseases also represent a significant portion of ongoing research.
States with lower access scores often face additional challenges, such as higher rates of cancer mortality and chronic illness. Mississippi, Oklahoma, and Arkansas, for example, have some of the highest rates of these conditions in the country, creating a critical necessitate for access to innovative treatments.
The Kivoa analysis suggests that states investing in medical infrastructure, including research hospitals and physician networks, are better positioned to provide their residents with access to clinical trials. The rise of remote trial participation, utilizing telehealth visits, offers a potential avenue for expanding access, but this option remains unavailable to many patients.