25+ useful clinical trial recruitment statistics for better results

If you've heard any statistics around clinical trial recruitment, it's most likely this one: approximately 80% of clinical trials are delayed or closed because of problems with recruitment. Additional troubling statistics include:

  • 9 out of 10 trials require the original timeline to be doubled in order to meet enrollment goals
  • 11% of research sites fail to enroll a single patient
  • Clinical trials account for nearly 40% of the US pharma research budget and total around $7B per year. The estimated cost of patient recruitment is 40% of the total budget, or $1.89B.
  • Clinical trial participation rates vary from year to year. Worldwide, 105,808 people participated in research in 2015, dropping down to 25,941 volunteers in 2016.
  • Delays can cost sponsors between $600,000 and $8 million for each day that a trial delays a product’s development and launch
  • Screen failure rates are significantly costly for sponsors and the cost (on average) across the industry is roughly $1,200 per failure.

But that's not the end of the story. Statistics around patient perceptions of clinical trials can help elucidate why patients do – and don't – participate, and help research teams better engage them.

Organizations such as Center for Information and Study on Clinical Research Participation (CISCRP) have contributed research to this area of interest. At Antidote, we worked together with SCORR Marketing and our nonprofit partners to survey 4,000 patients living with various conditions and from a range of demographic backgrounds to learn about patient preferences and perceptions by condition area. We hope that our findings can help research teams have better conversations with patients around research, and create studies that are both meaningful and accessible to them.

In this blog, we break down clinical trial recruitment statistics, from industry sources and from our own research, into these sections: 

  • Trust in clinical trial statistics
  • What role does clinical trial protocol play in patient recruitment?
  • Diversity in clinical trial recruitment statistics
  • Clinical trial recruitment through social media statistics
  • Clinical trial engagement during the COVID-19 pandemic statistics

Except where cited, the statistics that follow come from research conducted by Antidote.

Trust in clinical trials statistics

"I don't want to be a guinea pig."

Most clinical research professionals have heard that concern from patients who are hesitant to join a clinical trial.

Before joining a trial, it makes sense that patients want to weigh the risks against the benefits – but how can we present this information in a way that patients will connect with most?

In our research, we found that simply having the opportunity to talk with doctors, nurses or clinical trial coordinators – or fellow patients – involved in the research made a significant difference:

  • 92.7% of oncology patients say it's "important" or "very important" to talk with the doctors involved in clinical research before joining a trial.
  • 90.4% of chronic disease patients said it was "important" or "very important" to talk with the clinical trial coordinators and nurses involved in research
  • 86.8% of oncology patients say it's "important" or "very important" to talk with other patients like them before joining a clinical trial. In our survey, this was more important to oncology patients than it was to patients living with chronic/acute (in our sample, asthma/allergy and gastrointestinal disease patients) or chronic diseases (in our sample, lupus, kidney disease, multiple sclerosis, and type 1 diabetes patients).
  • Non-white individuals said talking with the hospital or company responsible for the research was more important than did their white, non-Hispanic peers (82.8% v. 73.8% and 77.3% v. 73.4%, respectively).

Giving patients the opportunity to communicate with those directly involved in research can help build trust. When that isn't possible, clinical trials may instead include information on the rationale behind a study in outreach materials. For cancer patients in particular, talking with fellow patients can be very important to their decision-making process. Today, patients are more able than ever to find others with the same individualized cancer mutations, giving peer input even more weight.

Providing information about the informed consent process can also help patients feel more comfortable about participating in research. Patients should understand that they can leave a clinical trial at any time, for any reason. If a placebo is being used, it's important to explain the likelihood that they will receive it. Some trials offer the active drug to everyone in the trial if it's found to be effective, another benefit that should be highlighted if it applies to your trial.

What role does clinical trial protocol play in patient recruitment?

An August 2018 Tufts Center for the Study of Drug Development Impact Report found that the total number of endpoints in a protocol increased 86% between 2001-2005 and 2011-2015. Protocol complexity is one important factor that has contributed to patient recruitment challenges — as trials become more specific, the patients needed become more difficult to identify. 

Scientific needs aside, there are protocol changes trial teams can make that have little-to-no impact on the scientific integrity of a trial. Research teams should carefully consider the burden of trial length, number of site visits, and specific medical procedures conducted. Our research found that: 

  • For patients with chronic/acute conditions, 93.6% said it was "important" or "very important" to know that they'll be able to complete the entire trial. 
  • When deciding whether to participate in a clinical trial, more than 92% of patients in all categories said it was "important" or "very important" for them to know they would be willing to undergo the medical procedures or tests in a study.

Logistical issues form another key barrier to clinical trial participation. While those who live in major cities may have relatively easy access to trial sites, an estimated 70% of potential clinical trial participants live more than two hours away from a study center.

Our research found that providing logistical support was most meaningful for those with chronic diseases. Limits to mobility may play a role here. In addition to offering home visits, cutting-edge technology like wearable devices can make it easier for patients to participate in research, while improving accurate data collection, too.

Key statistics include:

  • For all groups, having home visits for some or all of the trial check-ins ranked last in importance overall. However, individuals living with chronic disease were significantly (p<.01) more likely to say this was "important" or "very important."
  • Those with chronic/acute and chronic diseases also thought it was more important to have equipment to track or monitor their symptoms than their peers living with cancer did (p<.01). 
  • When analyzing results by race, home visits appealed more to Hispanic and non-white individuals, compared with non-Hispanic and white survey participants (62.4% v. 40.2%, p<.01 and 58.5% v. 38.4%, p<.01 respectively).

Diversity in clinical trial recruitment statistics

Clinical trials have traditionally struggled to match the demographics of trial participants to the real-world population of patients. For example:

One factor, of course, is an understandable lack of trust between the African American community and the research community due to historical harms such as the syphilis studies conducted at the Tuskegee Institute. However, some research suggests that trust levels are improving among both American American and Hispanic communities. Lack of trust may not be as significant an issue as trial teams think. Logistics, in fact, may play a larger role. 

Our key findings include: 

  • When analyzing results by race, home visits appealed more to Hispanic and non-white individuals, compared with non-Hispanic and white survey participants (62.4% v. 40.2%, p<.01 and 58.5% v. 38.4%, p<.01 respectively). 
  • Relative to white individuals, non-white individuals are more likely to partake in an observational trial. The same is true for Hispanic patients and women. 

Our findings suggest that tools for reducing the number of site visits, such as electronic patient-reported outcomes (ePRO) and home visits may improve trial enrollment for the patients study teams have the most trouble reaching.

We also found that the type of clinical trial in question affects how interested patients from different demographics are in participating:

  • In our survey, relative to white individuals, non-white individuals were more likely to partake in an observational trial. 
  • Hispanic patients and women were also more interested in participating in observational trials, compared with white and male respondents.

While it's important to increase trial participation in all types of trials, our findings suggest that engaging diverse communities in observational trials may offer a "gateway" into greater research participation in general.

Clinical trial recruitment through social media statistics

The healthcare industry has been slow to adopt to new technologies, and patient recruitment is no exception. A few key statistics around clinical trial recruitment and social media highlight that advertising is not the main approach study teams use to attract patients to trials – and advertising isn't really most patients' ideal way to find out about research, either. 

  • According to research conducted by CISCRP, just 5% of clinical trial participants heard about clinical research studies through online patient communities, and 16% heard about it from advertisements in general. Younger people, however, were more likely to have first learned of a clinical trial from online patient communities or through social media.
  • 73% of patients would like to hear about clinical trial opportunities from their doctor's office.
  • 42% would like to hear about trials from advocacy groups and nonprofit organizations.
  • 21% of patients would like to find out about trials through advertisements (printed, online, radio, TV).

At the same time, while patients may prefer to hear about clinical trial opportunities from their doctors, this doesn't always happen. In our survey, only 32% of patients reported that their doctors had ever shared information with them about clinical trials. 

Meanwhile, more patients are using social media than ever before. There are nearly 3 billion people actively using Facebook, Instagram, WhatsApp or Messenger each month. That includes 2.6 billion people using Facebook alone, and more than 2.3 billion people using at least one of their services every day. Users include members of all age groups, and other social media platforms like Twitter, Instagram, Snapchat, and TikTok continue to engage daily users. And when users are online, they're often talking about their health. A WEGO Health behavioral intent study found that: 

  • 87% of study participants say they share health information via Facebook posts.
  • 81% of study participants say they share health information via Facebook messages.

In addition, in 2019 a Pew research survey found that 80% of internet users search for health information online.

Sophisticated online targeting can make it easier to identify patients who are already interested in health topics. Hearing about trials from social media platforms may not be a patient's first choice, but if clinical trial patient recruitment companies can present trial information online in a meaningful way, patients are there to see it.

Clinical trial engagement during the COVID-19 pandemic statistics

Does a health crisis change digital engagement behaviors? How should digital marketers respond?

We recently dove into the impact of COVID-19 on consumer behavior and digital marketing across various industries. We took a close look at digital engagement in the healthcare industry, particularly in regards to digital advertising for clinical trial patient recruitment. Overall, in the early months of the COVID-19 pandemic, we saw some trends across all of Antidote’s clinical trial campaigns, regardless of therapeutic area:

  • a 27% increase in engagement rate 
  • a 43% increase in registration rate
  • an 18% increase in unique clicks
  • a 53% decrease in advertising cost (CPM)

While the pandemic has caused many clinical trials to pause, there is a heightened interest in clinical trials at large. Pharmaceutical companies and biotechs will need to move quickly and work with recruitment companies to harness this interest and turn it into participation to drive research forward. Maintaining meaningful patient engagement through this difficult time when patients are listening and engaging with digital spaces will be critical for clinical trial recruitment in the future. 

Successful clinical trial patient recruitment requires a nuanced approach to communicating with patients – and considering patient preferences by factors such as race and demographics. Learn more about our findings and how you can apply them to your efforts by downloading our whitepaper.