Identifying Patient Needs

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Mural Health Technologies, Inc., a new global provider of clinical trials technology, announced the launch of its new participant-facing technology platform, Mural Link at the CNS Summit in November. Sam Whitaker, co-founder and co-CEO of Mural Health, is no stranger to patient-facing technology. He founded Greenphire over 15 years ago to address participant payment technology. In this Q&A with Applied Clinical Trials, Whitaker discusses his time in the industry and patient needs in the current clinical trials market.

ACT: What have you learned from being in the industry for several years?

SW: The industry has talked about patient centricity for a long time, but it still feels like we are not putting our money where our mouths are. This is a cautious industry and opinions take a long time to change. But patient centricity is a real barrier to retention—each patient lost can delay drug approvals so we think the investment case for pharma companies is clear. Tech innovation done thoughtfully with real industry knowledge. Innovation really happens when businesses are given a chance to try something new and fail. This is counterintuitive to the spirit of our industry, where some companies maintain the status quo rather than disrupt their existing businesses.

ACT: Where did you see a gap in the market?

SW: Participant payments have not innovated to keep pace with what the average US consumer uses on a day-to-day basis. While consumers are most comfortable with digital payments such as Venmo, PayPal, Apple Pay, etc., participants payments are still stuck utilizing prepaid debit cards, which carry high fees, and are problematic for many reasons. Why is it that when participants enroll in a clinical trial, it has to feel like they stepped back 20 years in terms of the technology used?

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The real gap in the market though, is missing the opportunity to leverage participant payments as a strategic angle to engage with patients and help shepherd them throughout the trial, getting their feedback on trial design and addressing the things that cause them to dropout of trials

ACT: What is the biggest challenge in participant payment and how can this be addressed?

SW: Similar to other eClinical technologies, there is an issue with the number of suppliers of clinical payment technology. The industry has a single large provider of clinical payment technology. The few smaller competitors have adopted a “me too” product philosophy, building replicas of the dominant company’s product, with no incentive to innovate. This dynamic is not unique to payment tech. A similar trend can be found in other eClinical product segments. The solution relies on new cohorts of companies to emerge with next generation technologies, for example, IRT space, in order to force incumbents to either innovate or step aside. Sponsor and sites, and other buyers in the clinical trials ecosystem, should remain curious and seek out new entrants to learn about emerging strategies.

ACT: How do participant payment methods impact patient retention?

SW: Participant payments is critical for a study to deploy an effective retention strategy. Studies have long documented that financial barriers are among the highest reasons for loss-to-follow-up. The clinical trials industry continues to grow (est. 5.7% CAGR through 2030), increasing the demand for participants, and the economic environment continues to spiral (e.g. - rising unemployment, rising interest rates, and historic inflation). With 57% of US households not able to afford or manage an unexpected expense of $1,000, how can we expect individuals to take time off of work, incur expense to travel without delivering back to them a way to at least remain financially whole, during the study.