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Marginal Revolution ·Behind the news

Two Roads to Fast Clinical Trials, and the US Takes Neither

by Alex Tabarrok

Published 2026-06-23 11:19:28+00:00

Can the United States find a faster path for clinical trials without removing the government gatekeeper?

0:00 / 5:37 · Narrator Algieba

Context

Writing on 23 June 2026, Marginal Revolution looks at a friction point in American biotechnology: the speed of clinical trials. While the government’s new Operation TrialBlazer aims to close the gap with China and Australia, the approach remains uniquely American. The piece considers why other nations choose to bypass the central gatekeeper for early-stage research while the US focuses on making that gatekeeper more efficient. It raises a persistent question about whether a system built on total regulatory authority can ever compete with models designed for speed.

Show notes

A comparison of the Operation TrialBlazer initiative with the clinical trial regulatory models of China and Australia. While international competitors utilize investigator-initiated trials or decentralized ethics committee approvals to accelerate drug development, the United States maintains a centralized gatekeeper model. These domestic reforms focus on manufacturing and control standards but stop short of the deregulatory paths taken by global competitors.

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