Peek inside any American family's medicine cabinet and you're likely to find a drug that was tested in a foreign country. Pharmaceutical companies have been shifting research overseas for years and the number of foreign trials has skyrocketed. The Department of Health and Human Services reports more than a 2,000% increase in the number of foreign trials for U.S. drugs over the past two decades. In 2008, about 80% of drug applications approved by the Food and Drug Administration contained data from foreign clinical trials. The growth in developing countries and emerging economies in particular has been "explosive" said Arthur Caplan, MD, director of the Center for Bioethics at University of Pennsylvania's Perelman School of Medicine. Caplan explained the appeal of holding clinical trials in developing countries and the ethical issues raised by this research trend.