From Pilot to Practice: Insights into AI Adoption, Impact, and Expectations
In 2025, Medidata asked a simple question: how is the clinical trial industry actually using AI? One year on from the initial results – highlighting how the industry was aware of AI’s potential and beginning to experiment, and cautiously optimistic about its future – much, and simultaneously not much, has changed.
Medidata’s second annual industry survey – The State of AI in Clinical Trials | From Pilot to Practice: Insights into AI Adoption, Impact, and Expectations – gathered responses from senior clinical operations leaders across large and mid-size pharmaceutical companies, biotechs, and CROs in North America and Europe. Conducted by Everest Group, the survey found that budgets are rising sharply and awareness has broadened, but governance frameworks are still being established.
With AI spend expected to increase over the next 12–24 months, many still point to a trust gap between what AI is being asked to do and what it’s delivering today. Yet, what also seems clear is that the move from analytics-led AI to autonomous, decision-driving AI will be the industry’s next frontier.
The central theme of the 2026 report is transition: from exploration to execution, from pilot projects to programmatic investment, from AI as a tool for a handful of teams to AI as infrastructure for the whole enterprise.
As the report makes clear, the clinical trial industry is not deciding whether to use AI; it is trying to understand how to scale AI responsibly, equitably, and in a way that delivers durable value that goes beyond efficiency metrics to impact the speed and quality of the treatments that reach patients.
Download The State of AI in Clinical Trials report today for insight into how critical scaling barriers like weak data foundations hold organizations back from seeing results in key metrics like reduced protocol deviations and shortened trial timelines.
Offering 5 predictions for the next two to five years, the 2026 Medidata report offers the clearest picture yet of where AI is genuinely moving the needle, providing a stage-by-stage review of what AI can do today, grounded in both survey data and current evidence from the field.
About Medidata
Medidata has been powering smarter treatments and healthier people by supporting clinical trials through groundbreaking technological innovations for over 25 years. Medidata is a leader in AI-powered solutions across the entire trial lifecycle to accelerate clinical breakthroughs, reduce patient and site burden, and bring new therapies to market faster. Supported by one of the largest clinical datasets in the industry of more than 38,000 trials and 12 million patients, Medidata's Study, Patient, and Data Experiences are trusted by more than 1 million registered users across approximately 2,300 customers. A Dassault Systèmes brand (Euronext Paris: FR0014003TT8, DSY.PA), Medidata is headquartered in New York City and is recognized as a leader by Everest Group and IDC. Discover more at www.medidata.com. Listen to our latest podcast, from Dreamers to Disruptors, and follow us at @medidata-solutions on LinkedIn.
