The drug-approval process in Japan is far behind and the number of the approved drugs is far less than in other countries in the world. This lag has made it difficult for Japanese doctors to catch up with the global standards for the treatment of various diseases. This problem should be solved immediately. To overcome the drug lag and have a new drug approved without delay in Japan, it is mandatory to join multi-national clinical trials and apply for approval of a drug using the results. Therefore, several university hospitals with excellent performance in clinical trials have established UHCT Alliance to improve the trial environment, especially for multi-national trials, and to implement them more efficiently and safely.