According to the Federation of Hospital Internists, the number of non-profit clinical trials in Italy has been cut in half between 2009 and 2019, from 309 to 156. The pandemic has exacerbated the situation, reducing them to 98 in 2022, 68.3% fewer than in 2009. The Federation has created a "Manifesto for Clinical Research" in order to revitalize the industry. It is commonly known that Italy invests only 1.5% of GDP in R&D, compared to the EU average of 2.1%, amounting to approximately 11 billion euros each year. The portion of investment set aside for health is small: 10% of total investment, with barely a tenth going to non-profit research. Independent studies are critical in health research because they address requirements that differ from those of the market and can lead to breakthroughs in areas that typically elicit little interest from investors. To offset the decrease of independent clinical research, numerous causes must be addressed, ranging from staff shortages to a lack of funding to excessive bureaucracy. Internists believe it is also critical to implement reforms in the sphere of privacy, such as the ability to undertake retrospective observational research without particular patient consent.
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