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Distance as an Obstacle to Clinical Trial Access: Who Is Affected and Why It Matters

Access to clinical trials is valuable for patients as it provides the possibility to obtain novel treatments that are not yet commercially available. There are many barriers to access for patients wishing to join clinical trials, including travel distance. This report maps counties that are more than 60 miles from a county containing a Phase 2 or 3 clinical trial for a given disease in the past five years.

This report highlights the following points:

  • Clinical trials predominate in major metropolitan areas and their outlying suburbs. Coastal counties are more likely to host a trial than those in the country’s interior, a pattern that matches with population density.

  • Counties more than 60 miles from a clinical trial tend to have lower incomes and education levels, less access to the internet, and a higher rate of disability than closer counties.

  • Specific types of places tend to be far from clinical trials regardless of the disease being studied. Affluent suburbs, college towns, and urban cores are rarely over 60 miles from a trial, whereas agricultural counties (particularly in the Great Plains region) and American Indian Reservations are disproportionately likely to be over 60 miles from a trial.

  • Clinical trials are not always close to high-prevalence populations. There are “high-prevalence remote counties” that contain populations in the top quarter of disease prevalence and are over 60 miles from the nearest trial county. These locations are high-priority places for expansion of clinical trials.