Examining the Impact and Solutions to Extremely Delayed Site Payments from Sponsors

Anna Hrovat-Staedter
November 30th, 2017

Why do we need to improve the payment process between sites and sponsors?

Many clinical research sites cannot afford to finance the cost of conducting clinical studies for the months that it takes to collect payment from most study sponsors and CROs.

Invoicing to and tracking payments from sponsors recorded the second highest proportion of people reporting major pain across 25 research operations tasks, while maintaining positive cash flow recorded the fourth highest proportion.1 According to a report by the Society of Clinical Researchers, 66% of sites said they have less than three months operating cash on hand.2 Lastly, a 2010 Research Study indicated research sites carry a debt load of almost $400,000.3 These operational hurdles are not unique throughout the industry, and many sites and sponsors do not know how to reduce these challenges.

What is an extreme site payment delay?

In the Spring of 2017, Forte partnered with MAGI to perform an analysis on the state of the industry as it relates to site payments and to honor and recognize sponsors and CROs that pay sites promptly. Forte’s site customers contributed data for hundreds of studies across 142 sponsors and CROs with nearly 32,000 payment records. Based on this analysis, an extreme payment delay was defined as ‘a payment received 180 days or more after the negotiated timeline between the site and sponsor or CRO.’

Based on feedback and survey results from both sites and sponsors, it is clear there is still progress to be made to ensure sites are paid promptly and sponsors are motivated to pay sites in a timely manner. Conversations such as this help all stakeholders move toward solutions.

infographic extreme clinical trial site payment delays

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We surveyed over 120 individuals to investigate causes and effects of extremely delayed site payments. A total of 119 sites and five sponsors weighed in. The time it takes sponsors to pay sites for work completed is highly variable and often exceeds one year.

92% of site respondents have received payment from a sponsor or CRO 180 days or longer after the event date.

How has an extremely delayed payment impacted your site?

Mental challenges:

  • Reduced morale
  • Increased stress
  • Increased pressure from management
  • Employee dissatisfaction

Operational challenges:

  • Inability to pay bills and vendors
  • Affects budgets and salaries for upcoming year
  • Cannot continue with study time points or open new studies
  • Cannot pay participants or recruitment

Little to no impact:

  • 4% of site respondents reported extremely delayed payments had little impact on their site.

In your opinion, what was the driving reason the payments were extremely delayed?

  • 18% of sites didn’t select a driving reason
  • 8% of sites said they never experienced an extremely delayed payment
  • 2% of sites said staff turnover
  • 8% of sites said communication issues
  • 30% of sites said the approval process
  • 13% of sites said the contracting process, and 50% of sponsors/CROs agreed
  • 21% of sites said the invoicing process
  • 50% of sponsors/CROs said they never paid an extremely delayed site payment

What requests do you have for Sponsors/CROs you work with?

  • 30% request sponsors/CROs include payment details or changes in the invoice
  • 28% request better communication and communication processes
  • 27% request timely payments and adhering to contract
  • 15% request sponsors/CROs pay monthly versus other timelines
  • 7% request respect and understand impact of delayed payments
  • 6% request sponsors/CROs utilize online and automated payment systems
  • 5% request sponsors/CROs utilize information in EDC for payments
  • 2% request transparency
  • 2% request sponsors/CROs conduct in-person monitoring
  • 2% had other requests

Regarding site payments – what have sponsors/CROs you’ve worked with done in the past that has worked well for you?

  • Visit details for site payment; most sponsors don’t automatically supply this.
  • Sent information regarding what the payment was for, expediting reconciliation.

What have sites you’ve worked with in the past done that has worked well to make payments faster?

  • Enter timely CRF data and query resolution. In addition, participate in remote monitoring when possible.
  • Follow up with sponsors to ensure timely payments by managing clinical operations in a CTMS.

Learn more about solutions and tactics for site sponsor communications and financial planning:

Explore Forte Insights to learn about the Sponsor Invoicing Dashboard, a financial dashboard capturing the state of your invoices to help in assessing and reducing invoice payment turnaround time.

Appreciate being paid on time? Your study participants do too! Check out Forte Participant Payments to explore a simple and participant-centric solution for patient reimbursements.

References:

  1. https://go.forteresearch.com/state-of-the-clinical-research-industry-report-2017 
  2. http://www.appliedclinicaltrialsonline.com/aligning-data-entry-and-site-payment-incentives-clinical-trials-and-patients
  3. http://www.appliedclinicaltrialsonline.com/chasing-veteran-us-sites-out-enterprise