In spite of these strengths, BC’s ability to maintain a strong role in clinical research is threatened due to declining clinical trials as a result of the intellectual property regime, the reimbursement environment, and global trends.  Canada is losing its competitive position due to a decline of clinical research in the traditional countries (United States, Canada and Western Europe) and an increase in Japan and the emerging countries (China, India, South Korea and Eastern Europe).  Currently clinical research is conducted in 80% traditional countries and 20% emerging countries but this ratio is expected to change to 50%:50% within 5 years.  Moreover, cost, quality, and speed to recruit patients are frequent reasons cited for BC and Canada to be less competitive.  While BCCRIN will not be addressing the intellectual regime and reimbursement environment, it will streamline contract processes, increase access to institutions with well-trained clinical research personnel, create a strategy to increase patient involvement in clinical research, and actively market BC’s strengths to the pharmaceutical industry.

To provide models and ideas for BCCRIN, clinical research networks in England, Ireland, Scotland, South Korea, Japan, Australia, South Africa and Singapore were analyzed by reviewing prepared material and interviewing their senior representatives.  Government support of research is critical to the success of these clinical research networks. For example, the governments of Scotland, Ireland, Japan, Queensland and South Korea provide support ranging from $500,000 to several million dollars per annum for infrastructure to then attract inward investment into clinical research.  These organizations hired star researchers, stimulated investigator initiated clinical research, built personnel capabilities and actively marketed their services and expertise. The governments of these jurisdictions clearly see the value of research to their populations and economies.