This question isn't a question of logistics. It’s about trust, efficiency, and ensuring life-changing treatments reach those who need them most.
The idea of sites managing payments might look appealing in theory. But in practice, where staff are overstretched, and every task is vying for attention, complications emerge quickly. Participants feel the consequences. Sites feel the pressure. Sponsors waste time and resources. And when trials falter, everyone loses.
Clinical research thrives on relationships—with participants, sites, and sponsors. How payments are managed can either fortify these connections or undermine them entirely.
This is why the discussion isn’t theoretical. It’s real, pressing, and critical for the future of clinical trials. To figure out who’s truly equipped to do it right, we need to look deeper.
Advocates of site-managed payments argue that sites, being closest to participants, have unique insight into their needs. They see the cultural contexts, logistical struggles, and real-life barriers participants face. This understanding fosters trust and enables thoughtful, two-way communication. If anyone can handle payments with sensitivity, it’s the people interacting with participants daily.
Obviously, they’re not wrong. On paper, this case seems strong. But real-world complexities often tell a different story.
Site staff already manage a staggering workload. Between patient care, compliance tasks, and study protocols, adding payment management can push them to the limit. Mistakes like delayed or mishandled payments aren’t just frustrating; they damage the trust participants place in the trial and its organizers. Once trust is lost, it’s difficult to rebuild.
The ripple effect doesn’t stop there. Eroding participant trust impacts retention, strains relationships between sites and sponsors, and drags the clinical trial itself to a crawl. Each delay and misstep adds to the costs and challenges for everyone involved.
While the idea of site-managed payments is well-meaning, the logistical realities can derail even the best operations. Best laid plans of mice and men, as the saying goes. More than just an operational hurdle, it’s a risk to the trial’s overall success.
Payment services might seem like an unnecessary layer of complication to some. But their role is far more vital than it initially appears.
Every connection in clinical research is built on trust. Participants trust sites. Sites trust sponsors. Sponsors rely on the process to deliver. When payments are handled internally, that trust can fray. Financial matters can overshadow the compassionate care participants expect, reducing the relationship to a transaction.
External payment services are a key step to resolving this tension. By separating financial concerns from care interactions, they preserve the integrity of the site-participant dynamic. This allows sites to focus on what they do best: supporting participants and delivering research outcomes.
Beyond preserving relationships, these services ease the administrative burden that often overwhelms site staff. Timely, accurate payment processing is a matter of respect and professionalism. When managed correctly, these services mitigate risks, safeguard trust, and foster confidence in the trial process.
Services like Scout's can help keep trials cost-neutral for participants and ensure payments are handled without unnecessary strain on sites. This builds the foundation of trust and efficiency essential for successful trials.
Fair market value (FMV) and historical data are the traditional benchmarks for determining participant payments. While useful as starting points, they fall noticeably short of addressing the complexities of individual participant needs.
FMV relies on averages and standardized costs. But participants aren’t averages. Each one faces unique logistical and emotional challenges—from arranging childcare to taking unpaid leave or traveling significant distances. Historical data is similarly limited, reflecting past practices that don’t always align with modern clinical demands.
Algorithmic tools typically used to calculate FMV or benchmarks also have their oversights. While efficient, they often miss the human factors that shape participant experiences. No algorithm can understand the emotional burden of managing chronic illnesses while participating in a trial or the financial stress of navigating unpredictable expenses.
This challenge becomes even more pronounced on a global scale. The US-centric FMV model assumes predictable variables and outcomes, but global clinical research participants operate in vastly different economic, cultural, and logistical realities. There is no “global standard” for FMV, and applying a one-size-fits-all approach risks alienating participants and undermining trust.
To truly address these shortcomings, we need a balanced approach. Use data wherever possible, but pair it with human insight and flexibility. For example: Payment strategies should account for regional cost-of-living differences, unexpected travel expenses, or the value of a participant’s time and commitment.
We're not rejecting data, but enhancing it with a fuller understanding of real-world conditions. Payments informed by this approach don’t just “feel” fair; they’re genuinely supportive, promoting trust and goodwill across the trial process—whether in a local or global context.
Measures like holistic payments reimagine the role of compensation in clinical trials. They shift the focus to the participant experience while aligning with broader trial outcomes. This is about more than just numbers; it’s about reflecting empathy, fairness, and an understanding of participant realities.
Cultural sensitivity serves as the foundation for this approach. Clinical trials span diverse communities, each with specific customs, challenges, and expectations. A singular model of support can’t do justice to this diversity. Tailored strategies that respect local norms, logistical hurdles, and economic realities lead to broader inclusivity and better participant engagement.
But holistic support goes beyond financial considerations. It encompasses addressing the broader challenges participants face during trials. For example, different countries have varying approaches to standard of care, long-distance travel, and invasive procedures during visits. These factors can significantly impact an individual’s ability to participate and their overall experience. By leveraging the right providers—such as Scout—sponsors can ensure these challenges are met with thoughtful, localized solutions.
Transparency also plays a critical role. When support systems are clear, consistent, and free of hidden complications, participants trust the process. Delays, vague guidelines, or unclear reimbursements erode that trust and discourage participation. Payment providers, sites, and sponsors must communicate openly from the outset to ensure participants feel confident in how their needs will be met.
Finally, collaboration between sites, sponsors, and support providers is essential to success. Each party brings valuable insights to the table. Together, they can design systems that not only meet logistical needs but also honor the trust participants place in the trial process. Holistic support, in this sense, creates an ecosystem of fairness and practicality—removing barriers to participation, addressing participant needs comprehensively, and fostering trust.
Ultimately, clinical trials come down to one thing: relationships. Participants give their time and, in some cases, their health outcomes. Sites work tirelessly to support them while conducting high-quality research. Sponsors provide the resources that make it all possible.
The true glue that holds these relationships together is a shared commitment to valuing the participant’s sacrifice and experience as highly as the trial outcomes. This balance is not always easy to achieve, as sponsors face the pressure of bringing drugs to market. Yet, it’s this very alignment—where participant well-being and scientific progress are equally prioritized—that ensures trials succeed.
Holistic support systems play a critical role in fostering this balance. By addressing not just payments but the full spectrum of participant needs with fairness, clarity, and empathy, they strengthen every link in the chain. Participants feel valued. Sites face less strain. Sponsors gain confidence that trials are on track to succeed.
When participant needs are handled thoughtfully, it does more than just streamline logistics. It shows participants that their contributions matter and reinforces the trust needed to conduct impactful research.
This is the reality. Holistic support, far from being an optional convenience, is an indispensable partner in shaping a future where clinical trials can thrive. Thoughtful, participant-centered strategies create bonds built on respect, ensuring that participants and science progress side by side.
KimberLee Heidmann is Scout's Executive Vice President, Quality and Regulatory, Data Protection Officer. She joined the organization in 2001 and has served the life sciences in multiple capacities since 1998. Click here to connect with KimberLee on LinkedIn.