The promise of a booming clinical trials market led more companies to join the battle, even those with only expertise in the much simpler process of making generic drugs. Companies with no pharmaceuticals background, such as large Indian conglomerates known for infrastructure or oil, also formed joint ventures or launched clinical research businesses.

A 2009 report from the Centre for Studies in Ethics and Rights in Mumbai revealed investigators in private hospitals get paid recruitment fees of $1500 to $3000 per patient to run trials. Doctors also frequently receive other benefits such as paid trips abroad to attend conferences. It was noted that such financial incentives can tempt doctors to cut corners.

Indian Government regulators are trying to apply rules to strengthen ethical processes. Further to add transparency, WHO in 2007 added the registry to its own global database. For the time being, steps to reform trials are in progress. CTRI has raised concerns about strengthening ethics committees and also for investigators and committee members to declare conflicts of interest.