Russia
According to the FDA Report, Russia placed in the top 10 and ranked 2nd after the U.S. in terms of the number of subjects recruited. Russia is the world's 9th country by population (146 mln people), making it a patient pool more than sufficient for a study in almost any indication.
Czech Republic
The leading therapeutic areas in terms of the approvals in 2021 were Oncology, Neurology, Cardiology, Rheumatology. Besides, the country offers competitive advantages for trials in niche areas such as rare and orphan diseases, stem cell and gene therapies.
Hungary
Clinical trials in Hungary are in high demand, as the region is a unique combination of all the important aspects: fast enrollment, low prices, and a remarkable level of quality. Out 50 novel drugs approved by the FDA in 2021, 14 have undergone studies at Hungarian sites.
Spain
Today 145,000 patients are involved in 3,400 clinical trials in progress in Spain. While one out of three trials carried out in Europe already has Spanish participation, the country accounts for a 4.3% share of the global clinical trials activity with oncology as the leading therapeutic area.
Bulgaria
In 2014-2019 Bulgaria was placed in the top 10 and ranked 8th in terms of the number of subjects recruited for studies according to the recent US FDA Report. 13 out of 50 novel drugs approved by the FDA in 2021 underwent studies in Bulgaria.
Romania
Romania has been drawing a lot of interest for international Sponsors. The 12th largest state in Europe offers speedy start-up, specialized healthcare services, experienced personnel with advanced knowledge of eClinical solutions, and record recruitment rates across various therapeutic areas.
Poland
Poland is 10th place in the world by number of research sites (over 1,400). With a population of 38.5 mln people, it boasts successful recruitment rates, reasonable grants, and lower costs per patient than in the U.S., though higher than in Ukraine, Russia or Georgia.
Latvia
Being an EU member since 2004, Latvia boasts a harmonized regulatory and legislative environment for international clinical trials. The majority of studies fall within the therapeutic areas of oncology, neurology, psychiatry, and endocrinology.
Belarus
Belarus is a promising new player. Clinical research professionals are very particular about adhering to GCP standards. Local rules and standards are very close to those mandated by FDA and EMA.
Ukraine
Recruitment shows a significant number of eligible patients, including treatment-naïve ones. According to the MoH of Ukraine, leading therapeutic areas in 2020 are Oncology, Psychiatry, Neurology, Gastroenterology, and Hematology. The RA process takes up to 60 calendar days.

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