Spanish hospitals, at the forefront of clinical research in Europe
In order to host the studies, the centres must have the resources and infrastructure. Gregorio Marañón, La Paz, Clínic de Barcelona and Vall d’Hebron are some of the leading centres.
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To host the studies, the centres must have the resources and infrastructure. Gregorio Marañón, La Paz, Clínic de Barcelona and Vall d’Hebron are some of the reference centres. Spain has become an international leader in clinical trials. In 2024, the Spanish Agency for Medicines and Health Products (AEMPS) authorised 930 clinical trials in the country, placing it at the forefront in this area in Europe. Between 2012 and 2022, the pharmaceutical industry’s investment in R&D in Spain grew by 74%, rising from €479 million to €1.4 billion in those ten years; of this amount, €849 million went to clinical trials. But which are the centres that host them?
One of the main centres of reference is the Hospital General Universitario Gregorio Marañón in Madrid, where 637 phase I, II and III clinical trials are currently underway, 250 of them in the area of oncology. The centre studies a wide range of tumours, from the most common ones such as colon, pancreatic and melanoma to less common ones such as sarcoma. ‘We do not only clinical research, but also translational research (rapidly converting medical findings into applications for patients),’ explains Andrés Muñoz, assistant physician at the hospital’s Medical Oncology Department.
Bureaucracy is one of the main challenges in Spain to speed up research activity.
Another leading centre is the Hospital Universitario La Paz, where 424 new studies were initiated in 2024 (phase I, II and III), in areas such as oncology, neurology, cardiology, dermatology, immune-mediated or infectious diseases, rheumatology or nephrology. “One of the strengths of La Paz compared to other hospitals is that it is probably the only one in Spain that has all paediatric specialties. That is why the research in paediatrics is so powerful,” says Alberto Borobia, head of its clinical trials unit and deputy scientific director of the La Paz University Hospital Research Institute, IdiPAZ.
The list of reference health centres for clinical trials in Spain also includes Hospital Clínic in Barcelona, Vall d’Hebron University Hospital, Hospital Sant Joan de Déu, Hospital del Mar, Hospital Universitario 12 de Octubre, Hospital Universitario Ramón y Cajal, Hospital Universitario de Salamanca, Clínica Universidad de Navarra, Centro Integral Oncológico Clara Campal, Hospital Universitario Virgen del Rocío, Hospital Álvaro Cunqueiro in Vigo and Hospital Clínico Universitario de Valencia.
There are 35 accredited institutes in 13 autonomous communities with more than 31,000 scientists.
The latter is part of the Incliva Health Research Institute, under whose umbrella 649 studies are currently being conducted in areas such as cardiology, anaesthesia and resuscitation, haematology, digestive medicine, endocrinology, pneumology, neurology and oncology. The institution is known for its capacity to host phase I trials, which are the most complex because they test drugs for the first time in humans, and also for its powerful clinical trials unit for breast cancer patients.
Requirements
The coordinator of this unit, Begoña Bermejo, has been working in the field for 25 years. In that time, clinical trials ‘have changed a lot in terms of complexity,’ she says, especially because of the rigorousness of data collection and the numerous procedures that have to be put in place. But what determines whether one centre is chosen for a study over another? You need to have a large infrastructure to support the whole process, from start to finish, says Bermejo. ‘We, for example, have a day hospital to exclusively treat patients in oncology trials,’ he adds.
The director of Farmaindustria’s clinical and translational research department, Amelia Martín Uranga, points out that some of the main aspects that pharmaceutical companies value are that the centre has highly qualified, motivated and sized teams of researchers with professionalised resources. ‘And also the management of research, and the role of hospital management and their level of commitment’.
Alberto Borobia, from La Paz, adds that another key factor is having equipment to perform extraordinary procedures such as centrifuges, refrigerators, calibrated freezers and biosafety hoods to be able to prepare vaccines. Or having access to patients with a specific pathology and, of course, experience in the field.
Unfinished business and complementary models
Bureaucracy. One of the main challenges facing the country in the field of clinical trials is to guarantee the viability of research centres and reduce the bureaucratic burden on researchers in order to speed up their start-up, stresses Andrés Muñoz, who is also president of the Ethics Committee for Research with Medicines at the Gregorio Marañón Hospital, which ranks first in the national ranking of the Aemps in terms of studies evaluated, with 400 last year alone.
Resources. The specialists also stress the need to invest more public resources to promote academic trials, which in Spain only account for 17% of studies, while commercial studies account for 83%, according to Aemps data. ‘We are also working on developing tools to facilitate the participation of under-represented populations in clinical research,’ says Alberto Borobia, coordinator of SCReN, the platform of research units and clinical trials of the Carlos III Institute of Health (ISCIII).
Facilities. In Spain there are currently 35 health research institutes accredited by the Instituto de Salud Carlos III. Spread across 13 autonomous communities, they have a total of more than 31,000 researchers. “In our country there are excellent centres for clinical research in both public and private or subsidised healthcare. The public ones have the main weight, but there is increasing interest in doing trials in the private ones”, emphasises Amelia Martín Uranga, from Farmaindustria.
