Commentary|Videos|July 10, 2025

Removing Financial Barriers to Boost Trial Diversity

In this video interview, Heather Horville, solutions consultant at Greenphire, explains how upfront reimbursement, travel stipends, and flexible support services can empower more patients—especially those from underserved communities—to confidently enroll and stay in clinical trials.

In a recent video interview with Applied Clinical Trials, Heather Horville, solutions consultant, Greenphire, discussed the challenges of retention and trial timelines due to increasing financial and logistical burdens on patients. Horville highlighted strategies to address these issues, such as early planning, patient advocacy, and site selection based on local needs. For complex trials, engagement through diary entries and stipends, and human interaction via concierge services will be critical. Future improvements will emphasize a comprehensive patient journey, incorporating services like travel prepayment to enhance trial success.

ACT: What roles do reimbursement, stipends, and other participant support measures play in improving trial diversity, and how should these be operationalized at the site level?

Horville: There's a lot less resources and communities of lower socioeconomic status, not just financially, but we think of, do they have family support nearby? Do they have caregivers able to help out? Do they have access to transportation? Sites must always be in the loop, and aware of what's going on with our patients. They're on the front lines. If we're going to employ a strategy, we need to make sure that it's streamlined. We need to make sure that it's easy for sites, and we want to provide patients an optimal experience, so having flexible options based on where the sites are around the world and what the patient prefers is really important, but we do really want to make sure that we are implementing that strategy to reimburse patients, to provide stipends, to prepay for travel, and really help ensure that they can enroll confidently and that they can be retained.


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