ACT Brief Episode 4: New Data on Trial Delays, Hybrid Payment Models, and Managing Complexity

This is the Applied Clinical Trials Brief—your fast track to the latest insights in clinical research operations. In under three minutes, we’ll recap top stories, highlight expert interviews, and keep you current on what’s moving the industry. Let’s get into it.

On this episode, we’re spotlighting our three most-viewed articles from the past week—covering updated cost estimates for trial delays, evolving strategies for site payments, and how to navigate today’s increasingly complex protocols.

First, new research challenges a decades-old statistic. While it’s long been claimed that a day of clinical trial delay costs $4 million in lost sales, analysis of 645 drugs launched since 2000 puts the current figure closer to $500,000—and it’s dropping by as much as $100,000 each year. Direct daily trial costs average $40,000 across all phases, with Phase III topping $55,000. The findings highlight a growing disconnect between the rising risks of drug development and shrinking financial returns per approved product.

Turning to trial payments, a hybrid model—bringing some payment functions in-house while outsourcing others—can improve efficiency, reduce risk, and strengthen site relationships. Using a software-as-a-service platform internally gives sponsors real-time payment visibility and stronger site connections, while outsourcing global payments and compliance-heavy tasks can prevent costly delays. The right balance delivers faster payments and better site engagement without overwhelming internal teams.

And finally, protocol complexity continues to climb, fueled by advanced modalities, rare disease research, and personalized oncology. Seventy-six percent of trials now require amendments, each potentially adding hundreds of thousands of dollars in cost and delaying patient access. Best practices include early cross-functional collaboration, involving regulators and sites from the start, and building patient-friendly flexibility into designs. Creative problem-solving and high-touch partnerships are key to keeping complex trials on track and moving life-changing therapies to patients faster.

For more on this and other developments in clinical research, visit us at appliedclinicaltrialsonline.com. Thanks for listening to the Applied Clinical Trials Brief.