How Clinical Trial Research Sites Can Gain Access to a More Level Playing Field


Applied Clinical Trials

To overcome sponsor-related challenges and work to successfully secure more trials, there are tactical steps CROs can take.

For biopharma companies and clinical research organizations (CROs), the majority of clinical trials are dependent on a very small fraction of research sites. In fact, just 5% of research sites conduct 70% of clinical trials today1, which means 95% of sites are underutilized in clinical trials. This reality leaves trial sponsors struggling to meet patient recruitment and study startup deadlines, patient diversity needs, and time and budget constraints. It also, most importantly, negatively impacts patients and the overall advancement of medical science.  

The disparity between the number of active trials and tapped sites also creates a litany of challenges for research sites. In a survey Inato is currently conducting with SCRS2, a clinical research site community that represents over 9,500 sites in 47 countries, we found that an overwhelming 96% of research sites are looking to perform more trials. Just 4% reported that they were satisfied with the number of trials they’re performing, and still they indicated they were open to performing more.

Identifying more trials-especially those that are most relevant and likely to result in a successful engagement-proves difficult, however. Many sites continue to rely solely on existing, known networks, which unsurprisingly results only in finding the same, known trials over and over. Thus far, our research with SCRS shows that 52% of sites rely on existing sponsor/CRO relationships to source their trials, while just 6% employ dedicated business development staff capable of seeking out a broader range of trial options. What’s more, 70% of sites report feeling dissatisfied with their sponsor relationships. Sites are struggling with a lack of visible profile, equal partnership and clear communication with their sponsors, and there’s a significant administrative burden being placed on sites. 

Improving site visibility

To overcome sponsor-related challenges and work to successfully secure more trials, there are tactical steps sites can take, including:

  • Improving visibility-Our active research survey with SCRS indicates that 95% of sites struggle to get a foot in the door with sponsors. Existing sponsor/site partnerships are very relationship-dependent, so being proactive about improving site visibility to expand beyond known networks is essential.

  • Marketing unique characteristics-Public data sources tend to paint a picture of sites that isn’t always accurate. Historically, sites have rarely had a strong voice in describing their experience, strengths and differentiating attributes, so it’s important to begin taking ownership and marketing the characteristics that make sites unique.

  • Improving capabilities-More than 90% of sites never get feedback from sponsors on why they were not selected for a trial, according to our research with SCRS. To improve a site’s capabilities and become a stronger performer in future, sites need to be able to identify and work on their weaknesses.

Marketplace-based ecosystem

Ultimately, to improve their visibility, promote their unique characteristics and gather feedback to improve their capabilities, sites require a more accessible, transparent, marketplace-based ecosystem. By connecting supply with demand and eventually facilitating a financial transaction, marketplaces provide an online platform for supply and demand to efficiently find one another and transact seamlessly. In the clinical trial sector, doctors, their patients and research sites represent the supply component, and clinical trials (run by sponsors) represent the demand. 

By matching the most appropriate sites (i.e. the supply) to the most relevant clinical trials (i.e. the demand), a marketplace model offers the ability to finally flip the broken, traditional approach of sponsors repeatedly tapping the same few doctors and research sites. Furthermore, by empowering sites to apply to participate in trials that are most aligned with their interests and that of their patients, a marketplace-based ecosystem can allow sites-especially lower profile and untapped ones-to better promote themselves and gain access to a more level playing field.   

While their risk-aversion is understandable, sponsors’ long-held bias for maintaining existing relationships with tapped sites (rather than expanding to the vast majority of qualified and experienced sites) has created an exclusive clinical trials ecosystem that’s nearly impossible to penetrate, and one where patients who desperately need trial therapies (but can’t access tapped sites) lose out. A marketplace model is the only path forward to both increase the pool of patients involved in clinical research and leverage the 95% of untapped, qualified research sites. 


Robin Heiskell is the Head of Site Partnerships and Jennifer Kamara is the Product Marketing Manager, both of Inato



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