A country guide to clinical trials in Ukraine; pre-war research strengths, wartime disruption, resilient investigators, patient access, ethics review, and the cautious recovery of clinical research activity.
A note on context: This article covers Ukraine's clinical research landscape honestly; including both its pre-war strengths and the severe disruption caused by Russia's full-scale invasion in February 2022. The war has killed tens of thousands of civilians, displaced millions, and damaged or destroyed over 1,400 healthcare facilities. Any discussion of Ukraine as a clinical research opportunity must be held alongside the full weight of that reality. The Ukrainian researchers, coordinators, and patients who have continued this work under extraordinary conditions deserve that acknowledgment.
Ukraine is Eastern Europe's largest country by land area; 603,000 km², larger than France; with a pre-war population of approximately 44 million people. Kyiv, the capital, is a major European city and the historical center of Ukrainian medical and scientific education. The country has three full medical universities in Kyiv alone, with major medical faculties in Kharkiv, Lviv, Odesa, Dnipro, Vinnytsia, and Zaporizhzhia; a research infrastructure that took generations to build.
In the years before the war, Ukraine had established itself as one of Eastern Europe's most important clinical trial markets. Global pharmaceutical companies including Pfizer, AstraZeneca, UCB, Roche, and AbbVie ran trials there. Patient enrollment rates were extraordinary; in one large multinational academic consortium, Ukraine was enrolling patients at six times the rate of Georgia, itself considered a world leader. The reasons were straightforward: a 44-million-person population with high treatment-naïve rates, a universal healthcare system where advanced therapies were often unavailable, deeply motivated physicians and patients, and costs well below Western Europe.
On 24 February 2022, Russia launched its full-scale invasion. What followed is well known: destruction, displacement, and an enormous human toll. Clinical trial activity, which had been approaching 800 new starts per year, fell to fewer than 30 in 2022. By early 2024, the total number of ongoing trials stood at 400; approximately half the pre-war level. The road back is real but uncertain, and it is being walked by Ukrainian researchers and health professionals who have continued their work through air raids, power cuts, and displacement.
Ukraine's pre-war population of approximately 44 million represented one of Eastern Europe's most valuable clinical research demographics. The country's universal healthcare system provides broad coverage but has historically been unable to fund access to the most advanced therapies; a situation that creates strong patient motivation to join clinical trials offering investigational treatments. Ukrainian patients have demonstrated exceptional enrollment rates and exceptionally low dropout rates across multiple therapeutic areas, reflecting both clinical need and a strong cultural trust in physicians.
The war has profoundly altered Ukraine's demographic geography. Millions have been displaced internally and abroad. Researchers and clinical staff have relocated from eastern and southern cities (Kharkiv, Dnipro, Zaporizhzhia, Mariupol) toward Kyiv and western Ukraine (Lviv, Vinnytsia, Ivano-Frankivsk, Khmelnytskyi). This westward shift has paradoxically concentrated trial-capable infrastructure and population in the parts of the country furthest from active conflict; creating a more geographically compact research footprint, centered on cities that international sponsors can reach by road via Poland.
The enrollment benchmark: Before the war, Ukraine's patient enrollment rates were described by international researchers as exceptional; in one large multinational academic consortium (STRIVE, spanning 30+ countries on six continents), Ukrainian sites were enrolling at six times the rate of Georgia, itself a benchmark for fast enrollment. That underlying dynamic; motivated patients, motivated investigators, large treatment-naïve populations; has not disappeared. It has been disrupted. The researchers who built those rates are still there.
The arguments that made Ukraine attractive before the war remain structurally true. The question sponsors must honestly evaluate is operational risk, not scientific or regulatory merit. For sponsors considering Ukraine in 2025 and beyond, the relevant question is not whether Ukraine was a great trial market; it clearly was; but whether the western and central regions now present an acceptable risk profile for specific program types, and whether the Ukrainian research community's demonstrated resilience and the government's active reform efforts represent a credible foundation for future engagement.
44M population; world-class enrollment rates; large treatment-naïve pools; deep oncology, psychiatry, neurology investigator tradition; costs well below Western Europe; strong GCP culture; leading enrollment in major multinational academic programs.
30-day SEC regulatory review target; electronic submission system; VAT on IMP imports reduced to 7%; 75 new trials approved since war began; 181 new sites approved in 2024; RA audit volumes returning to 2021 levels despite reduced trial count.
Research activity consolidated in Kyiv, Lviv, Vinnytsia, Khmelnytskyi, Ivano-Frankivsk; furthest from active conflict. Supply routes via Poland established and operating. IMP logistics rerouted and functional. Parexel's Kyiv office never closed; maintained operations throughout.
EU candidate since June 2022; accession process underway; regulatory harmonization with EU CTR expected over time. Major pharma (Pfizer, AstraZeneca, UCB, Roche, AbbVie) maintaining presence signals long-term commitment. 2.2× increase in new submissions Q1 2024 vs Q1 2023.
Oncology was Ukraine's dominant therapeutic area before the war and remains the focus of most active and recovery-phase trials. Psychiatry and neurology were historically strong, reflecting Ukraine's significant psychiatric care infrastructure and large treatment-naïve patient populations for CNS conditions. Gastroenterology (including the ulcerative colitis trial at Vinnytsia City Clinical Hospital that was reported as actively enrolling in March 2024), cardiovascular disease, and hematology complete the major areas.
Sites are listed with geographic context reflecting the current security situation. Western and central Ukrainian cities currently offer the most stable operating environment. Kyiv, while occasionally targeted, has maintained research operations throughout the war. Eastern and southern sites (Kharkiv, Dnipro, Zaporizhzhia) have had reduced or suspended activity.
| # | Site | City / Status | Notes |
|---|---|---|---|
| 01 | National Cancer Institute of Ukraine | KyivActive | Ukraine's premier oncology research institution; Phase II–IV solid tumor and hematologic malignancy trials; University of Kyiv Medical School affiliate; maintained operations through the war; major global pharma partnership history including AstraZeneca, Roche, Pfizer. |
| 02 | Kyiv City Clinical Oncology Centre | KyivActive | Major Kyiv oncology center; Phase II–IV; broad solid tumor portfolio; active commercial Phase III enrollment; Kyiv's metropolitan patient access; operations maintained with wartime adaptations including electronic submissions and rerouted IMP logistics. |
| 03 | National Institute of Cancer | KyivActive | State research institute; oncology and hematology specialty; Phase II–IV; long track record of international commercial trial participation; GCP compliance maintained; actively recruiting for new study approvals in 2024. |
| 04 | Lviv Regional Oncological Center | LvivActive | Western Ukraine anchor; among the most operationally stable Ukrainian research sites; oncology Phase II–IV; geographic proximity to Polish border enabling reliable IMP supply chain; growing trial portfolio as western sites absorb relocated activity. |
| 05 | Vinnytsia City Clinical Hospital | VinnytsiaActive | Actively enrolling as of March 2024 (ulcerative colitis trial documented); central Ukraine; cardiovascular, gastroenterology, and oncology trials; one of the sites most cited by sponsors as demonstrating Ukraine's continuing research capacity. |
| 06 | Lviv Regional Clinical Hospital | LvivActive | Western Ukraine's largest hospital; cardiovascular, neurology, and internal medicine trials; high operational stability; access to Lviv region's 2.5M+ population; Phase II–IV commercial portfolio; reliable IMP logistics via Poland. |
| 07 | Khmelnytskyi Regional Hospital | KhmelnytskyiActive | Western Ukraine; cardiovascular, oncology, and endocrinology trials; among cities cited by UACR as stable for trial continuation; growing activity as research infrastructure concentrates in western Ukraine. |
| 08 | Ivano-Frankivsk Regional Clinical Hospital | Ivano-FrankivskActive | Carpathian western Ukraine; oncology and cardiovascular trials; stable operational environment; access to Ivano-Frankivsk region patient population; growing as western sites expand capacity. |
| 09 | Kyiv City Clinical Hospital No. 17 | KyivActive | Kyiv general hospital; oncology, cardiovascular, and rheumatology trials; Phase II–III commercial portfolio; operations maintained; one of the sites within the 181 new site approvals documented in 2024. |
| 10 | Institute of Oncology, National Academy of Medical Sciences | KyivActive | NAMS academic oncology institute; investigator-initiated and commercial Phase II–IV; long research tradition; active since before the war; maintained as part of Kyiv's stable western-facing research cluster. |
| 11 | Kharkiv Regional Clinical Oncology Centre | KharkivReduced | Major pre-war oncology research center; significantly reduced activity due to proximity to the front; some operations continuing; historically one of Ukraine's largest trial sites; included as part of the complete landscape; current feasibility requires individual sponsor risk assessment. |
| 12 | Dnipro State Medical University Clinical Base | DniproReduced | Pre-war major research center; no new cancer drug trials started since war began per reported data; included as part of the historical landscape; recovery dependent on security situation; investigators have relocated to western sites. |
Ukraine's premier oncology research institution; Phase II–IV solid tumor and hematologic malignancy trials; University of Kyiv Medical School affiliate; maintained operations through the war; major global pharma partnership history including AstraZeneca, Roche, Pfizer.
Major Kyiv oncology center; Phase II–IV; broad solid tumor portfolio; active commercial Phase III enrollment; Kyiv's metropolitan patient access; operations maintained with wartime adaptations including electronic submissions and rerouted IMP logistics.
State research institute; oncology and hematology specialty; Phase II–IV; long track record of international commercial trial participation; GCP compliance maintained; actively recruiting for new study approvals in 2024.
Western Ukraine anchor; among the most operationally stable Ukrainian research sites; oncology Phase II–IV; geographic proximity to Polish border enabling reliable IMP supply chain; growing trial portfolio as western sites absorb relocated activity.
Actively enrolling as of March 2024 (ulcerative colitis trial documented); central Ukraine; cardiovascular, gastroenterology, and oncology trials; one of the sites most cited by sponsors as demonstrating Ukraine's continuing research capacity.
Western Ukraine's largest hospital; cardiovascular, neurology, and internal medicine trials; high operational stability; access to Lviv region's 2.5M+ population; Phase II–IV commercial portfolio; reliable IMP logistics via Poland.
Western Ukraine; cardiovascular, oncology, and endocrinology trials; among cities cited by UACR as stable for trial continuation; growing activity as research infrastructure concentrates in western Ukraine.
Carpathian western Ukraine; oncology and cardiovascular trials; stable operational environment; access to Ivano-Frankivsk region patient population; growing as western sites expand capacity.
Kyiv general hospital; oncology, cardiovascular, and rheumatology trials; Phase II–III commercial portfolio; operations maintained; one of the sites within the 181 new site approvals documented in 2024.
NAMS academic oncology institute; investigator-initiated and commercial Phase II–IV; long research tradition; active since before the war; maintained as part of Kyiv's stable western-facing research cluster.
Major pre-war oncology research center; significantly reduced activity due to proximity to the front; some operations continuing; historically one of Ukraine's largest trial sites; included as part of the complete landscape; current feasibility requires individual sponsor risk assessment.
Pre-war major research center; no new cancer drug trials started since war began per reported data; included as part of the historical landscape; recovery dependent on security situation; investigators have relocated to western sites.
National regulatory authority; regulatory review target reduced to 30 days; electronic document submission system introduced during war; RA clinical audit volumes returning to 2021 levels; 75 new trials approved since May 2022; VAT reduction on IMPs to 7%; active engagement with international sponsors and UACR.
Industry association driving Ukraine's clinical research recovery; active engagement with global pharma sponsors; advocacy for Ukraine's return to the global trials network; organizes clinical trials industry events; coordinates outreach to 50+ pharma companies considering new trial starts.
Established April 2022 by clinical research professionals and ethicists; provides a platform for urgent questions about supporting trial participants during war; guidance on patient protection, investigator safety, and supply chain continuity; coordinates with IFAPP and international partners.
Kyiv office never closed during the war; country director relocated family to Germany but continued traveling to Ukraine for work; signed new contract with major pharma for Ukraine trial in 2024; among the most visible symbols of continued international CRO commitment to Ukraine.
CRO with maintained Ukrainian operations; regulatory and site management continuing; Phase I–IV; active 2024 trial portfolio; among CROs reporting that Ukraine's clinical sector 'is alive and still delivers results that are reliable, of good quality.'
Mid-size CRO with Ukrainian operations among its core markets; oncology, gastroenterology, and rheumatology specialty; Phase I–IV; among CROs maintaining active site relationships through the conflict.
Ukraine was, before February 2022, becoming one of Eastern Europe's most important clinical research markets. The full-scale Russian invasion disrupted that story profoundly; over 1,400 healthcare facilities damaged or destroyed, trial starts collapsing from near 800 per year to fewer than 30. What has happened since is, in its own way, a remarkable story: 400 trials still active as of early 2024, 75 new trials approved since the war began, regulatory review times cut to 30 days, major pharma maintaining operations, and Parexel's Kyiv office never closing. The Ukrainian research community's message to the international sponsor community is clear: "Not only are clinical trials needed in Ukraine, but Ukraine is needed for the industry." For sponsors willing to engage now; particularly in western and central Ukraine; the enrollment rates, treatment-naïve patient pools, and deeply experienced investigator community that built Ukraine's pre-war reputation are still there. The decision to engage is one each sponsor must make on its own assessment of operational risk. This article simply ensures that assessment is informed.
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