Reasons for Decline in Clinical Trial Approvals Despite Increase in Biomedical Investments

68 Ms He Ting Ru asked the Minister for Health with regard to the decline in clinical trial approvals from 178 in 2008 to 127 in 2023 (a) what are the reasons for the decline despite the increase in biomedical investments in Singapore; (b) whether there have been any policy changes that caused the decline; (c) if so, what are they; and (d) what is the Health Science Authority's assessment on why the decline occurred.

Mr Ong Ye Kung: We should first recognise Singapore's strengths and disadvantages in this field. We are recognised for our excellent healthcare infrastructure, strong research capabilities, experienced key opinion leaders and responsive and efficient health product regulation system. However, we are fundamentally limited by our smaller demographic base and hence, number of participants in clinical trials.

Over the years, regional players have invested heavily in building their clinical research capabilities and ecosystems, growing their global share of clinical trials. These larger countries often offer competitive advantages, such as lower trial costs and larger research participant populations. Hence, the competition for hosting clinical trials is getting more intense.

We will continue to enhance our attractiveness as a clinical trial destination, but in areas we are strong in. We are actively participating in regional and international clinical research networks. In 2023, about 80% of trials received by the Health Sciences Authority (HSA) were multinational clinical trials, highlighting our significant involvement in cross-border research. We have been focusing on early phase and innovative product trials that are potentially impactful and can lead to benefits for Singaporeans. Notably, in recent years, we have seen an increase in oncology trials to over 50% of trials approved in Singapore in 2023, which aligns with our focus on high-impact research areas. The Singapore Clinical Research Institute, with the support of the Ministry of Health, is also streamlining processes to reduce trial start up times, enhancing trial cost transparency and dedicating specialised talent and resources to support efficient trial operations.

Post-clinical trial, Singapore is an important production base, hosting many key players in the industry. Our HSA has become an internationally highly reputable reference agency, with which suppliers would want to register their health products. In other words, like all industries, we will continue to grow the parts of the value chain where we are strong in but may have to cede some areas where we are disadvantaged.