Healthcare has become increasingly expensive, creating significant burdens for patients globally. Recent reports indicate that the annual cost of healthcare for an individual in the United States is approximately $13,493. This figure represents the overall “cost of being a patient,” encompassing medical expenses, lost wages, and associated logistical challenges. Alarmingly, these costs continue to rise each year. Between 2014 and 2020, U.S. personal healthcare spending grew by an average of 4.8 percent annually.
Nowhere are the increasing costs and burdens more apparent than in clinical trials, which are vital in bringing new drugs and treatments to market and improving patient lives worldwide. A recent study found that participants in cancer clinical trials incur average indirect costs of $600 per month, totaling around $7,200 per year. Unsurprisingly, indirect costs present a more significant barrier to clinical trial participation for individuals with lower socioeconomic status.
Breaking Down Barriers to Clinical Trial Access
Clinical trials rely on volunteers who often face similar challenges to patients receiving general care, including high costs and logistical complexities. These burdens can discourage participation, often posing a threat to the success of clinical trials.
Recognizing this, stakeholders across the clinical trial landscape are placing greater emphasis on reducing these barriers to participation, as reflected in Greenphire’s 2024 Market Trends Survey. The findings reveal key areas where the industry is focusing its efforts:
- Financial Relief for Patients: 86% of research sites say the ability to pay or reimburse participants in real time is important for providing an optimal participant experience.
- Eliminate Logistical Barriers: Offering services like transportation and lodging assistance can reduce the stress and complexity of accessing care. These services play a crucial role in recruiting and retaining a more diverse patient population.
- Patient Empowerment Through Technology: An impressive 96% of research sites emphasize the need for user-friendly patient-facing technology to support the success of clinical trials.
The Critical Role of Diversity in Clinical Trials
When it comes to clinical trials, diversity and representation are not just regulatory requirements—they are scientific imperatives. Ensuring that trial populations reflect the diversity of the patients who will ultimately benefit from the therapies is critical to advancing equitable healthcare outcomes.
The U.S. Food and Drug Administration (FDA) has highlighted the importance of diversity through its draft guidance on Diversity Action Plans, which underscores the urgency of addressing these disparities, emphasizing inclusion plans that target age, ethnicity, race, and sex. These efforts aim to ensure trials are inclusive of underrepresented populations, paving the way for more accurate and applicable scientific findings.
Financial and logistical barriers remain among the top obstacles to achieving diversity. Recent insights reveal that:
- 86% of research sites believe eliminating financial and logistical barriers is essential to improving recruitment, retention, and diversity.
- 66% of sponsors and contract research organizations (CROs) agree that removing financial and logistical barriers is a key component of their diversity action plan.
The increasing emphasis on inclusion has further highlighted the barriers that hinder participation in clinical trials and underlines the need for innovative, patient-centered solutions. These include seamless, user-friendly technologies that empower participants throughout the duration of a clinical trial, whether simplifying the receipt and management of reimbursements, getting to and from appointments or staying on top of important study details. By reducing these hurdles, the industry can take meaningful strides toward greater diversity and equity in clinical trials.
Addressing Challenges to Enhance Participant Trust and Engagement
This year’s survey respondents identified the complexity of reimbursement processes, travel logistics, and stipend delays as barriers that can deter participants from enrolling and/or staying enrolled in a trial. Addressing these pain points is essential for fostering trust and boosting participation rates.
Real-Time Payments and Transparent Processes
Real-time payment capabilities were among the most highly prioritized solutions, with 94% of research sites and 96% of sponsors emphasizing their importance. Transparent processes—such as clear guidelines for reimbursement—were also highlighted as critical for building trust and reducing dropout rates.
Concierge Services
Travel and logistical support emerged as a major focus area, with 84% of research sites indicating that concierge services are necessary to alleviate participant burdens, covering all out-of-pocket costs and logistical arrangements. Offering these services was recognized as an effective tool for easing participant burdens, from scheduling transportation to arranging lodging and providing real-time assistance.
Tax Management
Unfortunately, there are potential tax implications for clinical trial participants as funds received are considered reportable income. When payments exceed $600 in a tax year, a Form 1099-MISC must be sent to the payee and reported to the IRS. According to survey findings, 74% of U.S. research sites believe this threshold should be raised or eliminated to reduce financial burdens and encourage greater participation in clinical trials. This is a sentiment that is agreed upon across the industry and there are various legislative efforts underway with the goal of mitigating the tax burden.
The Role of Technology in the Patient Journey
Technology emerged as a central theme in the survey, with participants emphasizing the need for integrated platforms that simplify the clinical trial experience. Key findings include:
Technology Ease of Use
An overwhelming 97% of research sites agreed that user-friendly technology is essential for enhancing the participant experience. Technology that simplifies processes and negates manual steps can reduce frustration and drive participant engagement. This not only increases protocol compliance but can significantly lower dropout rates.
Wearables and Telehealth
The adoption of wearable devices and telehealth visits offers new opportunities to make trials more accessible. Wearable device usage among U.S. consumers surged from 9% to 33% in just four years, while telehealth adoption has leveled off at approximately 38 times its pre-pandemic rate. These technologies allow participants to contribute data remotely, minimizing the need for frequent site visits while maintaining trial integrity.
Integrated Platforms
Stakeholders emphasized the importance of fully integrated systems to simplify administrative tasks for participants and staff. Single-login platforms managing registration, payments, travel and scheduling were seen as transformative. Automating data-triggered payments, like those tied to ePRO diary completion, was identified by 71% of sponsors and CROs as essential for enhancing participant engagement. These streamlined and integrated systems free sites and sponsors to focus on their core research goals while significantly reducing the burden on participants.
Shaping the Future of Healthcare
The future of clinical trials largely hinges on three priorities: fostering diversity, enhancing participant engagement, and streamlining operations. By embracing standardized processes, intuitive technology, and patient-focused initiatives, the industry can break down barriers, ensure inclusivity, and accelerate research. A steadfast commitment to these goals will not only drive innovation but improve participant experiences and deliver meaningful advancements in clinical trials and healthcare globally.

Ashley Leuthe
Ashley Leuthe is Associate VP, Product Management of Greenphire.