Using Micropayments for Better eCOA Adherence

Trial Better: A Clinical Trials Podcast

What is a micropayment? [02:16]
Micropayments are a small financial transaction. The threshold for what is considered a micropayment can vary based on industry, geographic location, and other factors. In clinical research, micropayments can influence and encourage patients to take complete any actions outside of a clinical visit that may be necessary.

Why are micropayments a hot topic right now? [02:58]
The clinical research space has reached an inflection point. Previously, there was resistance to methods that may have been considered coercive. Now, new FDA guidance has clarified how patients can receive compensation for their participation in clinical trials. There’s an overall industry-wide shift toward being patient focused and recognizing the sacrifices patients make to participate in a clinical trial, as well as making that participation more convenient.

What’s the level of sponsor interest in this type of technology? [04:15]

Sponsor interest in the use of micropayments is growing, along with recognition that sponsors who use micropayments can still engage with sites efficiently. Many sponsors are interested in being the “sponsor of choice”; sites want to be the “site of choice.” How can sponsors engage better with sites efficiently? That’s where this type of technology can come in.

How can sponsors address concerns of coerciveness if they’re interested in using this type of technology? [05:27]

There will always be a balance in the industry between innovating and remaining compliant with regulations and guidance. Vendors like Greenphire can provide consultation regarding this. With micropayments specifically, coercive compensation isn’t a concern - small amounts (>$10) simply encourage patients to continue to comply with protocol and what they’ve already agreed to as patients. Regulatory bodies are starting to see that and are generally supportive of that.

How can micropayments be used in specific therapeutic areas? [06:33]

Micropayments can be used in a variety of therapeutic areas, but are particularly effective in therapeutic areas where diary entries or measurements taken outside of a clinic visit are required, such as in diabetes or Parkinson’s disease. The payment serves as a reminder, encouragement, and “thank you” for the patient’s trial participation. The potential for micropayment uses cases is vast, but they tend to work best when patients need to be engaged in and mindful of their condition and report data outside of a site visit.

Are there measures other than completing a daily diary where micropayments can have an impact? [08:01]

Diaries are a common use case, but anything like ePROS (patient reported outcomes) are an opportunity for micropayments. It’s important to consider protocol design and address the site perspective - since the site will need to engage in the technology with the patient - as well as any other technology that will be used in the trial, to ensure that each piece of technology can communicate with the other.

What are the arguments against using micropayments? [10:23]

Most arguments focus on the burden micropayments can put on sites. It’s yet another technology that sites have to engage in, and it can be difficult to go through the set-up process and train staff. However, sponsors need to consider these things not just with micropayments, but all with technology, so it’s important to take a step back and determine if micropayments can provide a benefit to the trial.

How can you measure the effectiveness of micropayments? [12:10]

Multiple studies revealed that micropayments have the biggest impact on patient retention. With more complex protocols, finding the right patient can be like finding a needle in a haystack. Encouraging patients along the way helps ensure they aren’t dropping out of the study and can remind them why they chose to enroll in a clinical trial in the first place.

Where do micropayments fall in the future clinical trial landscape? [13:12]

Any time you’re engaging in a clinical trial, you have to consider the full spectrum of stakeholders engaging with technology and how it will impact them: ease for patients, efficiency for sites, and transparency at the sponsor or CRO level. It’s important to look toward the future in the industry and continue to recognize and thank patients for participating in the clinical trial as we move toward decentralized or digital trials.