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Population: 2,220,000

Largest cities: Riga (capital), Daugavpils, Liepaja

Approval Process

Latvia is the second largest Baltic country. It became EU member state in 2004, and its regulatory and legislative environment was stepwise synchronized with European legislation.


  • realistic start-up time: 3 months
Recruitment Potential

A great advantage for clinical research in Latvia is the access to a broad group of patients who have not been treated yet with modern therapies, mainly due to economical constraints. Therefore, large groups of treatment-naïve subjects are available for all major therapeutic areas.

Estimated deaths per 100,000 population by cause (higher than world/European average):

Diseases Latvia World Average Europe Average
Cardiovascular diseases 870.4 240.9 465.2
Neoplasms 310.8 222.1 236.2
Digestive diseases 57.4 32.0 30.9
Unintentional injuries 52.6 48.0 40.4
Diabetes Mellitus 28.7 21.6 19.4
Genitourinary diseases 19.1 18.8 20.1
Mental and substance use disorders 14.4 4.3 11.1
Musculoskeletal diseases 4.8 2.1 2.8

Data from World Health Organization

Latvia is ranked among top 3 countries in the EU with regards to: ovarian, uterine, kidney and stomach cancer incidence.

Latvia is a small country and usually it cannot deliver huge numbers of patients for the study on its own. But it is an excellent place to have your “first patient in” due to relatively short start-up period.

Investigators and Sites

There are approximately 100 sites in Latvia, mainly public hospitals (including medical university hospitals) and outpatient clinics.
Usually, sites are properly equipped, conducting therapeutic and diagnostic procedures according to the European standard of care.

Investigators are ICH GCP experienced, well educated, motivated and deliver high quality data.