According to a recent study published by Facts and Factors, the demand analysis of the global contract research organization (CRO) market size and share revenue is estimated to grow by about 65.5 billion by 2028. In the North American market alone, the contract research organization services market was valued at over 14 billion in 2022 and is expected to reach over 19 billion in 2027.
However, like any other niche organization, CROs have their own industry-related challenges. The truth is, even with the high demand for their services, today’s CRO executives still struggle with questions like, “Do they have the right tools and strategies to address their most pressing issues, such as patient retention?” Below, we gain deep insight into these pain points by speaking with CRO executives in different therapeutic areas. Join us as they share their thoughts on the top issues facing CROs today and offer advice on potential strategies and solutions moving ahead.
A Deep Dive Into Patient Retention Challenges, Strategies & Solutions
CROs understand that a solid reputation continues to bring them more sponsors and revenue. And part of this reputation is the ability to retain patients during each clinical trial phase. So what are some of the most significant pain points regarding patient retention? How vital is the relationship between clinical research coordinators and patients? And what strategies do CROs utilize to help maintain high retention levels? Endominance asked three CRO executives their thoughts on these crucial topics.
Brad Hightower of Hightower Clinical
Endominance first spoke with Brad Hightower, CEO of Hightower Clinical and host of Note to File, a podcast for clinical research sites. When asked about his thoughts on patient retention challenges, Hightower offers, “We often simply ask too much of patients and do not reimburse them enough. Clinical trial participation may require taking time off of work, finding childcare, driving across town, and spending hours on site. The standard fee per visit stipends that sponsors offer will simply not offset the time and effort to keep patients retained and engaged in a trial.” We also asked Hightower about how he feels the relationship between a clinical research coordinator (CRC) and the patient can affect retention rates. He states, “The relationship between CRC and patient is one of the most important reasons patients enroll and stay in trials. CRCs are (or should be) giving a high level of attention to their clinical trial participants and are, in many ways, another level of support for patients in their healthcare journey. We have to give patients a reason to want to participate in clinical trials, and in so many cases, this is achieved by building a relationship between CRC and clinical trial participants.”
Hightower also shares his views on current tech retention solutions (i.e., AI tools such as video monitoring and wearables) and if these tools are hitting the mark regarding patient engagement and retention. He reveals, “Frankly, I think the success of the currently available tech solutions is overexaggerated at this point. I have yet to see any widely used tech that is moving the needle in terms of patient engagement.” When asked his thoughts on how clinical trial sites can achieve better patient retention, Hightower suggests, “I believe the most successful patient recruitment and retention strategies will continue to be those that focus on the human connection. As long as technology can find ways to build this bridge better, rather than try to replace it, there is hope that tech solutions can drive progress.”
Scott Schliebner of TFS Healthscience
Scott Schliebner is the Senior Vice President of Clinical Development Services for TFS HealthScience CRO. He focuses on developing and growing business units related to rare diseases, pediatrics, and orphan drug development. When asked about his views on the most notable challenges regarding patient retention, he states, “Clinical drug development, in and of itself, is challenging and unpredictable. Overlaying the complexities of orphan drug development, along with rare diseases often found in children, on top of this difficult environment requires creative and innovative approaches. Clinical development within the rare disease space often includes the enrollment of an entire family and extended care network into a clinical trial. With clinical trials typically being conducted at a few specialized expert clinical centers, most rare disease patients do not live near their designated trial site. The additional stress and burden created from frequent travel to and from a clinical site and the accompanying time and financial burden of participating in a clinical trial often result in families either declining to participate or withdrawing from a trial mid-study. The unique challenges of developing new therapies for rare diseases really necessitate a completely new paradigm for drug development.”
Schliebner also offers suggestions for better patient retention and ways to decentralize clinical trials. He states, “Designing clinical trials that are logistically realistic and feasible for rare disease families is one place to start. By involving patients and families early in the drug development process, the patient voice and perspective can be included within the trial design phase, helping to ensure a clinical trial is designed in a manner that is suitable for patients suffering from a particular disease. Designing less burdensome trials increases patient enrollment rates, boots patient retention, lowers drop-out rates, and shortens overall clinical trial timelines. By providing patients and families with flexible options to participate in a decentralized trial, the use of home healthcare nursing, telemedicine, and remote data capture can move clinical trials from a clinical trial site directly to a patient’s home. Decentralized trial models that rely less on physical trial site visits, and more on patient-centered assessments, create studies that are more realistic for patients and, ultimately, studies that are completed faster.”
Michael Jarrett of QuesGen Systems
Endominance also reached out to Michael Jarrett, founder and CEO of QuesGen Systems, a CRO that provides comprehensive data management services to all aspects of social services solutions and clinical research. When asked about his thoughts on common retention pain points, he shares with Endominance, “So often, we see studies designed to benefit the research team and the institution, and the process of valuing the participant gets lost. The process is characterized by an extremely complex consent document (and process) followed up by complicated directions on what needs to be done.” Jarrett then states some of his main challenges, including:
- Keeping it [the process] simple to understand what the study is about and what the participant must do.
- Outlining why someone would want to participate – for the good of humankind? Compensation? Learning about their specific health and condition?
- Providing them reminders about what they need to be doing (taking the study meds, giving information, etc.)
When asked for insights on better patient retention, Jarrett offers, “That communicating regularly with patients and creating a connection to the people on the study team, not just a nameless process or institution, is vital to the retention process.”
At Endominance, we strive to better understand the obstacles today’s CROs face and are working hard to address those challenges. We also partner with businesses, organizations, and academic institutions to accelerate our mission of expanding our knowledge of holistic health. Through these partnerships, we also see the benefits of decentralized studies and are conducting many of our research trials remotely, providing patients with flexible options to participate in current and future studies. We are also developing “smart” solutions to some of the above clinical trial pain points with new biotech that aims to streamline the data gathering process. We understand the challenges today’s CROs face and believe creating a personalized gateway connecting clinical research staff and study participants can help today’s CROs reach new levels of patient retention and overall clinical trial success.
