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Clinical Trial Recruitment: Old Habits Die Hard

The estimated cost to enroll a patient in a phase I trial is $15,700, and the figures balloon from there with the recruitment costs doubling for a phase IV trial. Despite spending these exorbitant amounts, the clinical research industry is miserably failing to successfully recruit subjects. In the U.S. pharma industry, 40 percent of the collective budget is allocated towards recruitment, however, 90 percent of all clinical trials fail to achieve their recruitment goals on-time, and must extend the enrollment period. Many sponsors find themselves only adding to the budget by engaging in ineffectual recruitment practices.

Despite the emergence of the digital age, the standard (aged) approaches to recruitment persist: television/newspaper advertisements, physician referrals, press releases/public service announcements, posting fliers, physician referrals, random mailings, and cold calls are all still “in play.” These methods are often the most expensive and offer fewer targeting mechanisms to zero-in on subjects that match the protocol.

Older methods of recruitment remain costly.

To highlight the ineffectiveness of the “old school” recruitment methods, we turn to a National Institute of Health randomly controlled trial (RCT), of which 289 individuals were enrolled. Subjects were targeted via audio/visual media advertisements, mass transit advertisements, print media, fliers, the internet, and referrals. By breaking down the total amount spent and the number enrolled on each channel, we get the approximate cost to enroll a single patient:

  • Audio/visual media: $584 per enrollment
  • Mass transit advertisements: $522 per enrollment
  • Print-media: $390 per enrollment
  • Flier: $224 per enrollment
  • Internet: $92 per enrollment
  • Referrals: $12 per enrollment

An Industry Stubborn to Change.

Despite the larger sums required for traditional recruitment methods, sponsors and sites still turn to them to fill their studies. Data collected from a survey targeting CRO’s, sites and sponsors, shows all respondents received some portion of enrollment via traditional media, however, in this case, respondents report a mere 8 to 9 percent of enrollment stemming from advertisement across tv and radio. Not an impressive figure, given the expenditures related to traditional media advertisements.  

During a MobiHealthNews interview with Heather Bell, SVP, global head of digital and analytics at Sanofi, Bell proclaimed healthcare “slow” in adopting advancements in digital tech. Take for instance, that in the digital era of recruitment, 80 percent of internet users have searched online for information regarding a specific disease or treatment. With digital methods catching on, it’s worth questioning the use of archaic forms of advertisement in trial recruitment.

Digital tech companies like 1nHealth find the standard avenues of recruitment futile – the company scratches its head at those that employ less-effective, costlier approaches to trial recruitment. Utilizing traditional forms of media in recruitment seems akin to rapidly throwing dollars down the toilet.

In the last two trials, 1nHealth used digital tactics to recruit subjects three times faster and three times cheaper. Faster and cheaper sounds a whole lot more appealing than the slow and expensive approach, doesn’t it? 

For more on 1nHealth and its use of big data to attract previously un-touched subjects for clinical trial recruitment, visit