Global Research Requires Global Payment Solutions

Over the past 10 years, clinical development programs have worked to engage and enroll an increasingly diverse and international sampling of patients. However, working with research sites around the world can increase complexity, compliance risk and coordination challenges in an already demanding environment. Technology can automate manual processes to address many of these challenges, but only if that solution has the flexibility to deliver benefits across a diverse array of markets. What works for a US-based investigator may not be valuable for a site outside the US.

Payment automation solutions that are designed to optimize global research site performance and sustainability provide sponsors and CROs the ability to improve trial effectiveness by enabling more efficient, accurate and timely site payments and patient reimbursements around the world. During a Site Advocacy Group (SAG) hosted by the Society for Clinical Research Sites (SCRS) and our team, site staff from around the world discussed the opportunity for payment automation at their research site. 

Despite the diversity of roles and geographies among the group, there were many common themes, including:

• Frequent payments are critical. Monthly site payments are strongly preferred. There is a common misconception that sites outside of the US would not welcome a monthly payment cycle. During the meeting, however, there was a resounding demand from the group that 30-day payment terms were critical to the site’s ability to effectively support a trial. So why the disconnect? The problem is that with traditional site payment processes, there is a great deal of work that goes into compiling and the invoices and submitting requests for payments. This can be a daunting task if it needs to be done each month. When invoicing is automated and payments can be triggered by data, monthly payments are seamless, without additional work for all involved.  

• Pass through expenditures are burdensome. The ability to request and track payments for pass through costs via an easy-to-use portal is extremely valuable. The common challenge that the sites voiced was getting paid from their sponsors or CROs for costs that fell outside of their contracted agreement. On average, according to SCRS, these costs account for about 30 percent of the costs in a clinical trial. Sites were very optimistic about the impact that simplifying the pass through expense management process could have on site operations. Too often, the site staff who is chasing down these payments are also responsible for patient care. Through site payment automation, this work is taken out of the hands of the site staff to keep them focused on the trial and patient experience.

• Patient reimbursement drives retention and engagement. Reloadable debit card-based patient reimbursement and stipend payments were seen to dramatically impact retention and eliminate manual administrative burdens. The sites that participated in the discussion had either already had a favorable experience with a debit card-based patient payment solution or were eager to learn more about automating patient reimbursements and stipends.

• Close collaboration with ethics committees will support regulatory compliance. Stipends and reimbursements are permitted by ethics committees in the EU and are increasingly becoming a global standard in clinical research. Given some misconceptions present in the CRO industry, there was extensive discussion regarding the pre-requisites to stipends and reimbursement use in the various EU countries and surrounding regions. The sites represented in this diverse group agreed that the one prerequisite to stipend and reimbursement use is proactive engagement with the ethics committee.

• Communicating the value in a new solution is critical to acceptance. Sites are willing to use new software if the benefits are clear. All too often software is introduced to a site without a clear communication on the value it brings to the trial and clinical operations. When sites have an opportunity to really learn why a solution is being introduced – for faster payments, easier reporting, patient retention, they are more likely to adopt the technology.

In addition to the SAG, our team worked with the SCRS to conduct market research, surveying more than 700 global sites, to further explore the issues discussed in the meeting at a macro, global scale.

The findings of this research validated what was voiced among the group:

• 63% of sites prefer electronic payments

• 84% of sites prefer payment in thirty days or less

• 44% of sites employ personnel involved in accounting who also have other study-related duties

• 74% of sites report that personnel spend more than 15 minutes per patient visit on accounting activities

In conclusion, and without much surprise, in order to successfully support the globalization of clinical research, it is imperative that sponsors and CROs empower research sites around the world and treat them as valued business partners. Timely and automatic payments, access to financial information, with reduced manual processes can eliminate the resource drain that is distracting site staff from patient identification, recruitment, retention and care.

By Jim Murphy, CEO of Greenphire