Ranked as the 21st-largest Designated Market Area (DMA) in the country by Nielsen in 2017 3 , St. Louis has conducted approximately 12,651 clinical trials 1 . The greater St. Louis area significantly outpaces multiple more highly-ranked markets in terms of trial count, such as Sacramento (ranked 20th by Nielsen, and having 5,966 trials), Orlando (ranked 18th, and 7,825 trials), Tampa (ranked 11th, 9,597 trials), and Phoenix (ranked 12th, 9,738 trials), as well as several similarly-ranked cities, namely Charlotte (ranked 22nd, 4,937 trials) and Pittsburgh (ranked 23rd, 8,832 trials) among others 1,3 . As seen below, the greater St. Louis area includes cities such as Creve Coeur, Chesterfield, Florissant, and Farmington among others while also extending into southwestern Illinois.

“The Clinical Trials Landscape Project is a product of the proprietary database transformation that www.TrialScout.com is based on.” said Dr. Irfan Khan, CEO of Circuit Clinical. “Our hope is that these findings serve as a guide to those seeking care in the St. Louis area as clinical research as a care option becomes increasingly accessible in modern healthcare.” The clinical trials landscape of St. Louis overwhelmingly points to the contributions of Washington University to the industry, while also noting several other health systems playing significant roles as well.

St. Louis is performing very well in the clinical trial industry given its population of 2,911,823 5 . Similarly-populated cities include Charlotte (2,728,933), Tampa (3,091,399), and San Diego (3,140,069), all of which have conducted significantly fewer trials than St. Louis 1,4,5 . For additional comparison, the Atlanta and Dallas areas both have populations more than twice that of St. Louis (6,551,336 and 7,847,110, respectively), yet neither has conducted more than 2,000 trials than St. Louis (14,435 and 14,258, respectively) 1,5 .

Washington University is the most active health system in the St. Louis area, with 1,437 active trials* in 2018, accounting for roughly 44.3% of the city’s active trials last year. This is followed by BJC HealthCare (533 active trials last year, 16.4% of the total), Mercy Health (384 trials, 11.8%), Siteman Cancer Center (339 trials, 10.5%), and SSM Health (197 trials, 6.1%)1. At the individual hospital level, the Washington University Medical Center alone had 1,433 active trials last year, making it the single-most active clinical trial location in St. Louis. Other notable clinical trial locations in St. Louis include Mercy Hospital St. Louis (194 active trials in 2018), SSM Health Saint Louis University Hospital (173 trials), Barnes-Jewish Hospital (158 trials), Missouri Baptist Medical Center (107 trials), St. Louis Children’s Hospital (96 trials), Centralia Oncology Clinic (73 trials), and the Siteman Cancer Centers at Barnes-Jewish St. Peters Hospital, Barnes-Jewish West County Hospital, Washington University Medical Center, and South County (72, 70, 69, and 67 active trials, respectively)1.

As a whole, St. Louis has doubled its active clinical trial output over the past decade, from an estimated 1,643 in 2008 to 3,244 in 2018. As such, many clinical trial sites in the greater St. Louis area have seen significant growth in this department. Most notably, the Washington University Medical Center had 538 active trials in 2008, and its 2018 total was nearly triple that, with 1,433. Other locations with significant growth over the same time span include the Missouri Baptist Medical Center (23 active trials in 2008 to 107 in 2018), Centralia Oncology Clinic (2 active trials in 2009 to 73 last year), the Siteman Cancer Centers at Barnes-Jewish St. Peters Hospital (9 active trials in 2008 to 72 in 2018), Barnes-Jewish West County Hospital (a single active trial in 2008 to 70 in 2018), and South County (2 active trials in 2009 to 67 in 2018), the Missouri Baptist Health Care Center at Sunset Hills, and the Parkland Health Center in Bonne Terre (both from a single active trial in 2009 to 61 in 2018)1.

Alternative Clinical Centers in St. Louis-St. Charles-Farmington CSA (2018)1 Copyright © 2019 TrialScoutTM

Outside of the major health systems in St. Louis, there is also a multitude of alternative clinical trial sites in the greater St. Louis area that contribute to its landscape. The most significant of these sites is the Centralia Oncology Clinic, with its output and growth detailed above. Following that are St. Louis Clinical Trials (with 23 active trials last year, growing from 6 in 2008), St. Charles Psychiatric Associates and Midwest Research Group (with the same growth figures as St. Louis Clinical Trials), St. Louis Heart and Vascular (from three active trials in 2008 to 18 last year), Sundance Clinical Research (from 7 active trials in 2008 to 15 in 2018), and Millennium Psychiatric Associates in Creve Coeur (a single trial in 2008 to 14 in 2018)1.

Current Active Clinical Trials in St. Louis-St. Charles-Farmington CSA1,2 Copyright © 2019 TrialScoutTM

Additional analyses of the TrialScout database have been conducted to provide a current snapshot of the clinical trials landscape in St. Louis. The city’s current active trial total stands at 4,332; of these, 2,356 (or 54.4%) are currently recruiting for participation. The Washington University Medical Center remains the single-most active location in St. Louis, with a current 1,493 active trials occurring (874, or 58.5% recruiting); this medical center currently accounts for 34.5% of all active clinical trials and 37.1% of all recruiting trials in the greater St. Louis area. BJC HealthCare currently has 764 active trials, with 404 (52.9%) recruiting, accounting for about 17.6% of St. Louis’s currently active trials and 17.1% of its recruiting trials. Not far behind is Mercy Health, with 747 active trials (344, or 46.1%, recruiting), accounting for 17.2% of active trials and 14.6% of recruiting trials in St. Louis. Siteman Cancer Center currently has 573 active clinical trials (with 355, or 62%, recruiting), and these totals comprise 13.2% of active trials and 15.1% of recruiting trials in the area. Finally, SSM Health has a current total of 188 active trials (100, or 53.2%, recruiting) in St. Louis, and this makes up 4.3% of active trials and 4.2% of recruiting trials in the city2.**

Overall, St. Louis has shown that it is a significant part of the clinical trials landscape of the United States, outperforming several similar markets and even approaching trial volumes generally reserved for cities with absolutely massive populations. Several locations in St. Louis have also shown notable growth in their involvement with clinical trials, leading one to believe that this area will only become an even bigger player in the field with time.

*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)

**As part of our ongoing quality assurance process, we've enhanced and improved our trial accounting algorithm in order to capture clinical trials with inconclusive and/or unstated completion dates.

Approximate attributable data as per the TrialScout database collapse as of 4/11/2019. All data is derived from https://clinicaltrials.gov/ Approximate attributable data as per the TrialScout database collapse as of 7/22/2019. All data is derived from https://clinicaltrials.gov/ Lyons Public Relations Broadcast PR Solutions. (2017). 2017 Nielsen DMA rankings – Full list. Retrieved from https://www.lyonspr.com/latest-nielsen-dma-rankings/ 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 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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