Belgium, with a total of EUR 5.5 billion in R&D spending in 2021, is the country with the fourth largest research expenditure in the EU and the first per inhabitant.  As a recent study from Deloitte sponsored by the Belgian pharmaceutical industry association,, shows, Belgium is also a leader in clinical trials, maintaining its position within the top three European countries for clinical trials. Read on for a look at the factors behind Belgium’s strong position as a clinical trials destination.  

A European Front Runner

The number of clinical trial applications approved in Belgium has grown steadily, going from 506 in 2016 to 574 in 2021. In terms of the number of clinical trials set up per inhabitant, Belgium has remained within Europe’s top three countries over the past ten years.

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Commercial trials have a larger footprint in Belgium compared to other European countries. In 2021, 80 percent of the clinical trials applications approved were from biopharmaceutical companies as opposed to universities or academic centres.

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Reasons for Success

Some of the key factors behind Belgium’s success as a clinical trials destination are the strong presence of the biopharmaceutical industry, the quality of the country’s infrastructure— including its research centers and over 70 hospitals— and the level of expertise of researchers and authorities, including the Federal Agency for Medicines and Health Products (FAMHP). In addition, Belgium offers a favourable regulatory environment, having introduced a new clinical trials law in 2018 to ensure the practical implementation of the EU Clinical Trials Regulation (CTR) in Belgium. Under the new law, Belgium has continued to implement its ultra-fast approval procedures for clinical trials, particularly for phase 1 trials — a procedure that take barely 15 days.

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Cancer Trials Lead

Cancer research leads in terms of the number of clinical studies carried out in Belgium by therapeutic area, with 175 launched in 2020, accounting for 19 percent of the clinical trials in Europe to test drugs against cancer. After cancer, Belgian trials are focused on viral illnesses (10 percent), nervous system disorders (8 percent), respiratory tract diseases (6 percent), cardiovascular diseases (5 percent), with othe diseases making up the remaining 37 percent.