Emory Healthcare Dominates Clinical Trial Industry in Atlanta

Written by Jack Beecher, TrialJourney Data Analyst

“The Clinical Trials Landscape Project is a series, born out of the proprietary database transformation that www.trialjourney.com is built on, that allows us to see where clinical trials are being conducted throughout the country,” said Dr. Irfan Khan, CEO of Circuit Clinical. “Our goal with this project is to provide patients, providers, and healthcare administrators with new insights that will help them understand clinical research as a care option and inform choices in regards to it.” Atlanta’s landscape primarily reflects the notion that it trails smaller markets in the clinical trial industry, while Emory Healthcare stands above all others within the city.

Although the Atlanta Combined Statistical Area (CSA) was ranked as the 10th-largest Designated Market Area (DMA) by Nielsen in 2017³, it does not rank in the top 10 U.S. metropolitan areas for clinical trials. A total of 14,477 clinical trials have been conducted in the greater Atlanta area, placing it 14th in the country in this regard¹. Some similarly-ranked DMAs boast significantly more trials than Atlanta; Boston, ranked 9th by Nielsen, has 26,732 clinical trials conducted, while Houston (ranked 8th) has conducted 17,431. On the other hand, Atlanta has outperformed other similarly-ranked DMAs in Tampa (9,636 trials and ranked 11th by Nielsen) and Phoenix (9,775 trials and ranked 12th)^1,3. The Atlanta CSA includes nearby cities such as Marietta and Sandy Springs, and extends as far outwards as LaGrange, Thomaston, Athens, and Rome among others, as seen in the map below.

Distribution of Clinical Trials per Zip Code¹

However, these figures do not take population into account. The greater Houston area has a population of 5,641,077; despite having nearly a full million fewer residents than Atlanta (whose estimated population is 6,551,336), it has conducted roughly 3,000 more trials^1,5. Furthermore, although Atlanta outpaces Tampa and Phoenix rather handily in trial volume, its population is more than twice that of Tampa’s (3,091,399 residents) and nearly two million greater than Phoenix (4,737,270)^1,4,5. Atlanta’s most immediate comparable in terms of population is the Miami CSA, which has a population of 6,832,588; despite a population difference of roughly 300,000 from Atlanta and being ranked six spots lower by Nielsen, 21,625 clinical trials have been conducted in Miami, about 7,000 more than Atlanta^1,5.

CSAs comparable to Atlanta in regards to trial volume include Minneapolis (15,094 trials) and Denver (15,386 trials), which have conducted about 600 and 900 more trials than Atlanta, respectively, while having much smaller populations^1,5. Compared to Atlanta’s 6,551,336, Minneapolis has a population of 3,946,533, and Denver is even less populous with 3,515,374⁵. Atlanta is, however, outperforming its most immediate comparable in regards to trial volume, Dallas, which was ranked 5th by Nielsen and has conducted about 200 fewer trials than Atlanta (14,309) despite boasting a population that exceeds Atlanta’s by more than a million (7,847,110)^1,3,5.

Atlanta’s clinical trials landscape is dominated by Emory Healthcare, which had 1,442 active^* clinical trials in 2018, accounting for 45.2% of active trials in the entire CSA. This is then followed by Children’s Healthcare of Atlanta (255 active trials last year, 8% of Atlanta’s total), Piedmont Healthcare (172 active trials, 5.4%), Grady Health System (156 active trials, 4.9%), and Northside Hospital (129 active trials, 4%). The most active individual clinical trial location in the greater Atlanta area is Emory University Hospital, with 564 trials in 2018. The next most active sites include Emory’s Winship Cancer Institute at the Emory University Hospital (359 active trials in 2018), Egleston Hospital (183 active trials in 2018), Emory University Hospital Midtown (151 trials), Northside Hospital in Atlanta (110 trials), Piedmont Atlanta Hospital (93 trials), and Grady Memorial Hospital (90 trials) among others¹.

Over the past decade, the Atlanta CSA has seen steady growth in overall trial volume; there were 3,188 active clinical trials in the area in 2018, versus 1,929 in 2008. The Emory University Hospital again stands above other clinical trial locations in Atlanta for growth; it grew from 296 active trials in 2008 to 564 last year. Its Winship Cancer Institute more than doubled in volume, from 138 trials in 2008 to 359 last year. Egleston Hospital nearly doubled its output over the same period, from 96 trials in 2008 to 183 in 2018. Notable growth is also seen for Emory University Midtown Hospital (more than tripling from 42 trials in 2008 to 151 in 2018), Northside Hospital in Atlanta (57 trials in 2008 to 110 in 2018), the Emory Clinics at Clifton Road (20 trials in 2008, 71 in 2018) and Executive Park (14 trials in 2008, 52 last year), and the University Cancer and Blood Center at the Clarke County Medical Oncology Clinic (26 in 2008, 66 in 2018)¹.

Outside of major health systems, Atlanta’s alternative clinical trial sites also comprise a relatively significant portion of its landscape. The most active of these sites is the Atlanta Center for Medical Research, with 66 active trials in 2018, boasting more trials than several hospitals in the area. This location has also seen demonstrable growth over the past decade, growing from 12 active trials in 2008 to its 2018 total. Following this are the Northwest Georgia Oncology Center in Marietta (60 active trials in 2018 from 27 in 2008), iResearch Atlanta (41 active trials in 2018 from four in 2012), GI Specialists of Georgia (from four active trials in 2008 to 38 in 2018), and Atlanta Gastroenterology Associates at Emory St. Joseph’s Hospital (12 trials in 2008, 32 in 2018)¹.

Further analyses have also been conducted on the TrialJourney database to provide a current look at the clinical trials landscape of Atlanta. To start, the current count of active trials in the greater Atlanta region stands at 3,931. Of these, 2,006 (51%) are currently recruiting for participation. Unsurprisingly, Emory Healthcare still towers over all other health systems in Atlanta, with 1,565 currently active trials (806, or 51.5%, of which are recruiting). Emory currently accounts for 39.8% of Atlanta’s active trials and 40.2% of its recruiting trials. Within this system, the Emory University Hospital has a current total of 520 active trials, comprising 13.2% of active trials in Atlanta and 33.2% of Emory’s active trials. 319 (61.3%) of the hospital’s trials are recruiting, accounting for 15.9% and 39.6% of recruiting trials within the CSA and health system, respectively. The Winship Cancer Institute contributes another 428 active trials (201, or 47%, recruiting) to Atlanta’s landscape, accounting for 27.3% of Emory’s active trials, 10.9% of Atlanta’s active trials, 24.9% of Emory’s recruiting trials, and 10% of Atlanta’s recruiting trials. Children’s Healthcare of Atlanta has 297 active trials at the moment (199, or 67%, recruiting), comprising 7.6% of Atlanta’s active trials and 9.9% of its recruiting trials. Northside Hospital is currently the next-most active health system in Atlanta, with 215 active trials (95, or 44.2%, recruiting), accounting for 5.5% of Atlanta’s active trials and 4.7% of its recruiting trials. Finally, Piedmont Healthcare has a current total of 209 active trials (81, or 38.8%, recruiting), making up 5.3% of active trials and 4% of recruiting trials in the CSA².^**

Overall, Atlanta appears to be another U.S. city that is performing less clinical trials than what would be expected given its size and population. While Atlanta’s contribution to the overall landscape of the country is by no means insignificant, more trials have been conducted in much less-populated metropolitan areas. This does, however, mean that Atlanta is perhaps an area to keep an eye on for acceleration in this field in the future.

To follow the clinical trial landscape series, visit the TrialJourney Clinical Trials Landscape

*Active in 2018 = Active at any point in 2018 (Start date of study is before 12/31/2018 and end date is after 1/1/2018)

**As part of our ongoing quality assurance process, we've enhanced and improved our trial accounting algorithm in order to capture clinical trials with inconclusive and/or unstated completion dates.

1. Approximate attributable data as per the TrialJourney database collapse as of 4/11/2019. All data is derived from https://clinicaltrials.gov/
2. Approximate attributable data as per the TrialJourney database collapse as of 7/22/2019. All data is derived from https://clinicaltrials.gov/
3. Lyons Public Relations Broadcast PR Solutions. (2017). 2017 Nielsen DMA rankings – Full list. Retrieved from https://www.lyonspr.com/latest-nielsen-dma-rankings/
4. U.S. Census Bureau. (2018) New Census Bureau population estimates show Dallas-Fort Worth-Arlington has the largest growth in the United States. Retrieved from https://www.census.gov/newsroom/press-releases/2018/popest-metro-county.html
5. U.S. Census Bureau, Population Division. (2019). Annual estimates of the resident population: April 1, 2010 to July 1, 2018 – United States – Combined statistical area; and for Puerto Rico. Retrieved from https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk

Abbreviation Guide

• Children's Healthcare - Children's Healthcare of Atlanta
• Grady Health - Grady Health System
• Northside - Northside Hospital, Inc.
• Emory University - Emory University Hospital
• Winship - Winship Cancer Institute of Emory University
• Children's Healthcare- Children's Healthcare of Atlanta - Egleston Hospital
• Emory Midtown - Emory University Hospital Midtown
• Northside - ATL - Northside Hospital - Atlanta
• Atlanta Center - Atlanta Center for Medical Research
• Nothwest GA Onc. - Northwest Georgia Oncology Centers - Marietta
• GI Specialists - GI Specialists of Georgia
• AGA - Atlanta Gastroenterology Associates at Emory Saint Joseph's Hospital