Who spends the most on clinical trials?

Start with what this ranks, because it is not R&D budgets. These are the research payments sponsors disclosed to CMS for US physicians and teaching hospitals, tied to specific trials, rolled up from reporting subsidiaries to parent companies. A floor on trial spending, auditable to the NCT number, and a fraction of any company's total R&D line.

Ranked that way, across 4,219 US drug trials and $5.2B in disclosed payments, two companies sit alone at the top.

The leaderboard

AbbVie leads with $899M across 565 trials. Eli Lilly follows at $883M across 489. The gap between them is under 2%, close enough that a single big program or a reporting quirk could flip the order. Call them co-leaders: together they hold more than a third of every disclosed drug-trial dollar.

Then the field drops off fast. Sanofi is third at $427M, Regeneron fourth at $286M, Bristol Myers Squibb fifth at $232M. The rest of the top ten: Otsuka $152M, Takeda $150M, Pfizer $150M, Daiichi Sankyo $135M, UCB $109M. The top ten together hold 66% of the money, out of 267 parent companies with disclosed drug-trial payments.

One filter to know: this table covers drug-development trials only. Device makers show meaningful disclosed spending too, mostly through registry and post-market studies, and they get their own piece rather than a footnote in this one.

Two ways to be big

Breadth and intensity are different strategies, and the table shows both. Sanofi reaches $427M on 381 trials, about $1.1M each. Bristol Myers Squibb spreads $232M across 254 trials at $0.9M each, the thinnest average in the top ten.

The intensity play is Pfizer and Otsuka. Pfizer's $150M sits on just 70 trials, $2.1M each, the highest per-trial average on the board. Otsuka is right behind at $2.0M across 75. Fewer, heavier bets against a wide portfolio of lighter ones.

Phase mix is strategy made visible

Where the money lands by phase says what each pipeline is doing right now. Otsuka has 62% of its disclosed spend in phase 3, the most late-stage book in the top eight, driven by its psychiatry and nephrology programs. Lilly is the opposite pole with 35% in phase 1, the early edge of its cardiometabolic pipeline, which also makes cardiometabolic Lilly's biggest area at $314M against AbbVie's oncology-led $346M.

Pfizer is the outlier: only 16% of its disclosed spend sits in phase 3, with 56% in phase 2, the shape of the Seagen oncology portfolio it absorbed. Oncology leads five of the top ten sponsors; Sanofi is the only one led by infectious disease, at $130M of vaccine and antibody work.

What the ranking measures, and what it misses

Two cautions before anyone quotes this table. First, it counts disclosed US physician and site payments, so companies that route trial money through CROs, non-US sites or academic networks will rank lower than their true activity. Second, subsidiaries are folded into parents (Seagen and Seattle Genetics into Pfizer, Shire into Takeda, Pharmacyclics and Allergan into AbbVie), so the totals reflect today's corporate map, not the org chart when the payments were made. The method and its blind spots: where the data comes from.

Used with those cautions, the table is fast competitive context. A sponsor's disclosed total, trial count and phase mix sketch its US development posture from public records, before a single conversation with management. Per-trial and per-patient benchmarks for pricing that posture are in what a clinical trial costs and cost per patient by phase.

Common questions

Which pharma company spends the most on clinical trials? By disclosed US research payments on drug trials, AbbVie at $899M, with Eli Lilly effectively tied at $883M. The two together hold over a third of all disclosed drug-trial dollars.

How much does Eli Lilly spend on clinical trials? Lilly shows $883M in disclosed research payments across 489 US drug trials, led by its cardiometabolic programs at $314M. That is a floor on US physician and site payments, not Lilly's R&D budget, which is many times larger.

Is this the same as R&D spending? No. R&D budgets include discovery, manufacturing, global operations and everything else a pipeline costs. This measures one auditable slice: disclosed payments to US physicians and teaching hospitals, tied to specific trials.

Data notes

Figures come from CMS Open Payments research payment records matched to ClinicalTrials.gov by NCT number 2020–2024 (January 2026 file release). Sponsor totals are per-funder amounts (shared trials credited to each funder only for what it paid) rolled up from reporting subsidiaries to parent companies via crosswalk; rolled totals reconcile exactly to the $5.8B trial total. The leaderboard covers the 4,219 trials with a drug-development phase ($5.2B); registries and device studies are excluded. Combined-phase studies count with their later phase in the mix chart; early phase 1 counts with phase 1. All figures are floors on true spending.

This article is a market-data benchmarking resource derived from publicly available CMS Open Payments and ClinicalTrials.gov data. Reported figures are disclosed industry research payments and represent a floor on trial spending, not R&D budgets, complete trial costs, or financial advice. Healthcare DealHub is not affiliated with CMS or the US government.