Site growth

Adding a therapeutic area: what it takes and what it pays

By TrialNotice · Updated
Clinical research team reviewing study options around a conference table
Short answerAdding a therapeutic area makes sense when there is sponsor demand, an investigator with credibility in the area, the needed staff and equipment, and a realistic patient source. ClinicalTrials.gov shows demand is uneven: oncology has thousands of recruiting industry funded US trials, while most other areas have a few dozen to about 120. Patient access is usually the deciding constraint.

Where is the demand?

Recruiting, industry funded trials with US locations on ClinicalTrials.gov, queried October 4, 2026 (ClinicalTrials.gov). Counts depend on search terms and are a demand signal, not a precise census.

Therapeutic areaRecruiting industry trials (US)
Oncology2,763
Obesity121
Heart failure118
Type 2 diabetes102
Alzheimer's and dementia93
Chronic kidney disease79
Depression78
COPD71
Parkinson's disease68
Lupus54
Ulcerative colitis47
Psoriasis45
Crohn's disease45
Atopic dermatitis44
Schizophrenia43
Rheumatoid arthritis43
Asthma40
MASH39
Migraine36

Oncology was also 38% of all trial starts in 2025 (IQVIA), and buyers describe oncology, CNS, and rare disease as the most strategically valuable capabilities (Objective IBV). High demand also means more competing sites.

What does a new area require?

  1. An investigator with credibility in the indication. Sponsors want investigators invested in the area (Bourne Partners).
  2. Staff and training for new procedures and assessments.
  3. Equipment and space, such as infusion chairs, imaging access, or specialty storage.
  4. Time: oncology and CNS take the longest to reach first patient in (Applied Clinical Trials), and CNS screen failure averages 57% (Tufts CSDD).
  5. A patient source, which is the piece most often missing.

How do you test demand before investing?

  • Check sponsor pipelines; most companies publish them (Bourne Partners).
  • Count competing sites near you on ClinicalTrials.gov.
  • Count the specialists near your site who manage the condition, using the CMS NPPES registry. They are your future referral base.

Why build the referral network first?

A new therapeutic area usually means patients your practice does not see today. They are in the offices of local specialists. Starting those relationships before the first study arrives means you can answer feasibility with a real patient source. Sites value a balanced therapeutic mix so demand swings in one area do not sink them (Bourne Partners).

Get your study in front of the right local physicians

TrialNotice builds a physician referral pipeline around one active study. We identify relevant local physicians within driving distance of your site, send study aligned direct mail, follow up by email and LinkedIn, track engagement with recipient level QR codes, and route warm responses into your site team's workflow.

Talk to TrialNotice

Sources

  1. ClinicalTrials.gov API, recruiting industry funded studies with US locations, queried October 4, 2026
  2. IQVIA, "Therapeutic Areas Driving Clinical Trial Growth" (2026)
  3. Objective Investment Banking and Valuation, "Valuation of Clinical Research Sites: What Buyers Look For"
  4. Bourne Partners, "Update on the Fundamentals of Clinical Trial Sites" (SCRS Global Site Solutions Summit takeaways, October 2025)
  5. Applied Clinical Trials, "New Benchmarks for Trial Initiation Activities" (Tufts CSDD)
  6. Applied Clinical Trials, "Can Recruitment and Retention Get Any Worse?" (Tufts CSDD screen failure study)

Keep reading

Two clinical research site staff members reviewing a growth plan together in a bright office
Site growth

How to grow a clinical research site: a practical playbook

Research sites grow by building a record sponsors can verify: enrollment, startup speed, and screen failure. Here is what the data says about site growth, why sponsors reuse sites, and a six step playbook.

 Research site director presenting enrollment results to sponsor representatives across a conference table
Site growth

How research sites get more studies from sponsors and CROs

Sponsors award more studies to sites that enroll reliably, start fast, and forecast honestly. Here is how sponsors choose, why new sites face a slower path, and what a site can do to win repeat work.

 Sponsor clinical operations team reviewing site maps and performance charts on a large screen
Site growth

How sponsors and CROs select clinical trial sites

Sponsors shortlist sites with historical data and epidemiology, send feasibility questionnaires, then choose on patient access, past enrollment, and startup speed. Here is the process, how it evolved, and what it means for sites.