As the pandemic has demonstrated, clinical trials — and the new treatments they bring — can benefit millions of people. With the advancement of clinical trial software, local health systems outside of major cities also have the opportunity to get involved in clinical trials.
But many local health systems are still reluctant to participate in research because they’re worried about extra costs, a lack of facilities or infrastructure and not having enough physicians or patients to carry out a trial successfully. In other words, community hospital systems and physicians believe in the social benefits of clinical trials but aren’t sure whether they’re worth the financial burden. Although sponsors provide financial backing to conduct clinical trials, those payments often don’t include the startup costs of creating a feasible clinical trial site, like hiring and training staff, acquiring software and setting up facilities.
But the costs of clinical trials are more than offset by the revenue they bring to communities and the innovative (and usually free) treatments they bring to patients, including those from underserved communities. With the help of clinical trial technology and a mix of funding sources, smaller health systems can participate in clinical trials and reap their economic benefits.
Decentralized clinical trials boost local economies and help patients.
Industry sponsors — a group that includes pharmaceutical companies, biotech companies and medical device companies — invested more than $15 billion in clinical trials at U.S. research sites in 2017. This investment funded 4,516 studies with roughly 920,000 participants and is estimated to have generated $27.4 billion in additional revenue for the communities where trials took place. The additional revenue came primarily from spending by contract research organizations (CROs) and industry employees that clinical trials brought to the area.
Because of clinical trial technology, trials can take place at research sites across the U.S. instead of only within major cities. Clinical trial software allows major sponsors and academic medical centers to share documents and data with smaller community clinics in rural areas that serve underrepresented patients. These patients can then receive cutting-edge treatments that previously would have been unavailable to them.
But even though many health systems in low-income areas would love to offer their patients free treatments, those health systems often struggle with the initial startup costs of clinical trials previously mentioned. They especially struggle to maintain a research infrastructure between trials.
Community health systems need funding to run tech-enabled trials.
If a health system forms a working relationship with a large pharmaceutical sponsor, that sponsor might be willing to fund the infrastructure for studies, as well as for running actual trials. Sponsors are especially eager to work with community health systems with diverse patient populations, and they’re often willing to provide the clinical trial software needed to make those collaborations possible.
But if health systems want to run investigator-initiated or grant-backed trials, finding funding for technology and equipment becomes more challenging. Running independent studies alongside sponsor-funded clinical trials is good for research because it allows physicians to test treatments not associated with a specific drug or those they’ve developed themselves.
So, how do health systems solve this funding problem? Many turn to multiple sources to create a portfolio supporting research or to get a jump on the startup costs. About 35.6% of clinical trials in the U.S. in 2014 were industry-sponsored, but the federal government and philanthropic organizations can fill in the gaps, leading to a rich variety of trials.
Funding from grants or nonprofits can also help health systems pay for the technology needed for all of their studies. Research sites benefit from a unified technology ecosystem that works for investigator-initiated or grant-backed trials, as well as sponsor-funded ones.
Provider-based research networks can support local health systems.
Provider-based research networks (PBRNs) give local physicians financial, technological and educational resources for clinical trials. A PBRN is usually based out of a large hospital and connects local physicians with experienced researchers from academic medical centers.
How research organizations and tech companies can help.
Clinical trials can bring millions of dollars in revenue to local health systems, improve the internal performance of those systems and provide free treatments to underserved patients. Technology makes it possible for clinical trials to move out from major cities to local communities that previously couldn’t offer cutting-edge treatments.
But to make these benefits a reality, both for-profit and nonprofit clinical research organizations must commit to funding clinical trials in underserved communities. In turn, healthcare technology companies must make connecting pharmaceutical sponsors to local clinics and health systems a fundamental part of their services.