Increasing Site & Patient Convenience For Oncology Clinical Trials

February 04 2021  

It’s time to start addressing the financial & logistical impact for patients & sites.

In 2019, the American Cancer Society Cancer Action Network (ACSCAN) released a report calling on the industry to begin breaking down barriers to patient enrollment in oncology research. Many recommended actions pertain to financial and logistical barriers that impact patients and research sites.

According to the ACSCAN report, out of all potential qualifying patients for a trial, only 44% of them have access to an available trial, only 27% are eligible for the trial, and only 8% are able to successfully enroll in a study. These are just the barriers leading up to trial participation. Once a patient is enrolled, there are many obstacles that can impact patient retention in a study.

Let’s discuss some of the obstacles facing oncology research today and highlight innovation opportunities to transform the way sites, sponsors, and CROs interact.

Oncology Trials are Frequently Behind in Enrollment

Fortunately, we live in a time of tremendous medical discovery, especially for those who are living with cancer. However, many oncology trials are frequently behind in enrollment. In fact, 20% of oncological clinical trials fail as a result of poor patient enrollment (ASCAN 2019). This statistic was recently supported in the recent SCRS – Greenphire Financial Challenges Survey; where sites responded that recruitment is their top challenge.

This means, after a potentially lifesaving treatment has been identified, it can be delayed in getting to market not as a result of an issue with the medication or protocol, but as a result of a lack of knowledge of a trial’s existence, or challenges with recruiting and retaining patients.

Increasing patient convenience and access is something that we can control and improve with new tools, offering a show of compassion and value for individuals offering their bodies and time for research. Clinicians today are considering new ways to recruit – and retain – participants in oncology trials. In addition to increasing awareness of trials as a treatment option, offering reimbursement for time and expenses and/or assisting patients with travel is key to engage patients. While providing reimbursements and stipends used to be uncommon in cancer research, the tide is changing. In a February 2021 survey clinical research sites, 60% said that they are seeing a shift in the acceptance of removing financial burdens for participants of oncology clinical trials.

Patient Diversity Is Deficient In Clinical Research

Given that 94% of US-based individuals have never participated in a clinical trial, there is tremendous opportunity to build awareness and improve access to clinical trials across diverse populations. According to an FDA study, only 4% of Oncology trial participants were African American and 4% Hispanic.  From a research standpoint, it is critical that trials include a diverse population of patients, to fully assess a treatment with racial and ethnic factors in mind.

Thankfully, there are increasingly adopted ways of promoting inclusivity that are well within these studies’ grasp. It starts with building trust in diverse communities through education and partnership, but also providing tools to remove obstacles and increase access, such as transportation.

Accessibility Hurdles Hamper Clinical Trial Participation

For those individuals who are interested in participating in a clinical trial, the trial itself may have some distance from an individual’s home, and they may not have access to transportation. According to this report from the American Cancer Society Cancer Action Network (ACSCAN), only 1 in 4 cancer patients have access to clinical trials at the location where they receive treatment.

Protocols for rare cancers or those that require specific genetic mutation will often need to expand their geographic reach to get the limited number of existing patients into a trial. Providing a travel solution is imperative for patient retention in these trials. Connecting patients to rideshare services, as well as helping to arrange the logistics of other forms of travel such as air or rail may be the difference between a patient being able to continue with a trial or not.

Site Solvency

We have discussed some of the hurdles to patients, but what are the obstacles that impact the sites that conduct oncology trials? Sites have a mission to treat patients, however, they must also run efficient business processes. Running a clinical trial is not easy for research sites, and it does not help that they are often reimbursed slowly from sponsors and CROs. Many sites report that they have no more than 3 months of cash on hand yet may wait over 120 days to be paid.  And with COVID-19, sites have additional financial burdens of cleaning and PPE. Introducing shorter, 30-day pay cycles can help ensure sites are not having to pay for anything out of pocket and reduces the overall site burden.

How to Move Forward

It seems that a paradigm shift must take place. Patients are donating their time and bodies for trials that serve the greater good. Taking away barriers to these cancer clinical trials does not just help the patient – it helps the overall research at hand, and ultimately helps advance these lifesaving medicines.

To move this imperative research forward, financial and logistical considerations must be on the table. Being more sensitive to the financial, physical, and logistical challenges of a cancer diagnosis especially in disadvantaged communities helps patients have more access to what they need, and ultimately studies more access to the resources they need.

To learn more about how financial and travel automation can help clinical trials, read more about our suite of patient convenience solutions.


Dave Espenshade, Greenphire
Dave Espenshade
Vice President of CRO Partnerships

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