Patients are free to participate in clinical trials performed outside of Germany. No German specific requirements in the other country for such cases.
Follow-up visits and treatments done back in Germany may have to be approved by separate clinical trial authorization in Germany.
There is no law explicitly forbidding patients from another country to join a trial in in Germany therefore in principle it is possible as long as ethical and regulatory standards are fulfilled.
No requirements in Germany if a patient want to join a trial in another country.
No additional approval needed by national Health Authority if the trial is authorized in Germany. 
No requirements in Germany if a patient want to join a trial in another country.
As long as a patient is able to fully understand the content of the informed consent and fulfils the inclusion/exclusion criteria, it should be permissible for a non-German resident to participate in a trial.
Travel insurance (if taken out for the trial) should cover international travel in such cases.
Travel arrangements usually organized by 3rd party vendor (to ensure data protection) as a commercial sponsor usually covers travel costs
Different patient languages need to be considered (translator might be required during patient visits)
ICFs and other patient-facing materials (depending on the involved EC) might need translation to the patient´s mother tongue depending on the patient´s language skills.
If different languages (not German) are being used to inform patients the respective documentation needs to be submitted to EC (required documentation depended on involved EC, from Certificates of translation up to submission of all translated documents incl. translation of insurance documents)
Patients not included in the German healthcare system through the mandatory healthcare insurance and potentially a lack of access to historic health information (medical records) of the patient could cause issues at sites.
Not known
Patients not included in the German healthcare system through the mandatory healthcare insurance and potentially a lack of access to historic health information (medical records) of the patient could cause issues at sites.
Not known
Travel insurance (if taken out for the trial) should cover international travel in such cases.
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