One of the most challenging aspects of conducting clinical research is its global nature, as there are significant variances in regional requirements and obstacles. Regulatory, cultural and logistical factors all impact trial design, start-up and execution.  Greenphire’s 2024 Market Trends Survey highlights the distinct priorities and hurdles faced by nearly 400 sponsors, contract research organisations (CROs) and sites around the world.

From participant engagement strategies to the role of technology, this report offers valuable insights into the sentiments of the European clinical trial market – and how it compares to the US.

A positive participant experience is crucial for recruitment, retention and trial success. Both regions aim to remove financial and logistical barriers but with emphasis placed on slightly varied areas of support.

• Flexible payment methods: 56% of European sites and 74% of European sponsors and CROS prioritise offering a variety of payment options (eg, card, virtual card, bank transfer). This is slightly lower than the 64% of US sites and just above the 62% of US sponsors and CROs that emphasise this notion
• Concierge services: 47% of European sites and 70% of European sponsors and CROs view providing logistical support for participants as important compared to 63% of US sites and 68% of US sponsors and CROs
• Real-time payments: US respondents place slightly higher importance on speed of payment to participants (87% US sites and 81% US sponsors/CROs vs. 78% European sites and 70% European sponsors/CROs).

Both regions face struggles related to enrolling diverse populations. However, introducing initiatives to increase diversity in clinical trials remains a focus in Europe and the US.

• Hurdles to diverse enrolment: 56% of European sites find enrolling diverse participant populations difficult, compared to 41% of US sites
• Cultural and regulatory alignment: 83% of European sites believe removing financial and logistical barriers directly impacts diversity in recruitment, while this figure is 86% for US sites
• Diversity action plans in motion: 59% of European sponsors and CROs noted that they incorporate financial and logistical support for participants into their diversity initiatives, showcasing a commitment to inclusive trials. This commitment is reflected in 70% of US sponsor and CRO respondents.

Adopting efficient, patient-, site-centric and GDPR-compliant technology is a shared goal globally but particularly in the EU. Additionally, we see a common sentiment regarding the lack of up-to-date data in support of study cost planning. The survey indicated:

• Ease-of-use: 100% of EU sites cited ‘ease-of-use’ as critical for participants when adopting trial technology, while 96% of US sites agreed
• Reducing effort for sites: 94% of EU sites and 95% of US sites emphasise the importance of reducing the effort and time spent completing tasks with technology to support their clinical trials
• Predictive cost data: Only 44% of European sponsors and CROs reported having reliable data to predict trial costs incurred by participants, compared to 41% of US sponsors and CROs, highlighting the need for better source data to support financial planning.

Sites are the backbone of clinical trials worldwide, but operational pressures and administrative burdens remain a challenge no matter the region. Key insights from the survey include:

• Participant recruitment: 47% of European sites see recruiting and retaining participants as a challenge, compared to 36% of US sites
• Protocol complexity: 69% of European sites face challenges with intricate trial protocols, compared to a similar 68% among sites in the US
• Budget challenges: 44% of European sites identified insufficient budgets to cover expenses as a significant hurdle, compared to 36% of US sites
• Growth potential: despite these hurdles, 56% of European sites expect to maintain their trial volume, with 33% anticipating growth in the next year.

Operating across Europe requires adaptability, given the region’s diversity and scale. The survey highlights these insights:

• Recruitment and retention: 63% of EU sponsors and CROs identify recruitment as a challenge, lower than the 77% in the US. This is particularly interesting as we compare the significant difference between site and sponsor/CRO responses – sites being 47% and 36% respectively
• Automation and efficiency: 66% of sponsors and CROs in the EU emphasise the importance of data-triggered payments in providing a positive participant experience, reflecting a growing push for automation. In the US, this figure rises to 77%
• Participant-centric services: key priorities ranked for EU sponsors and CROs include flexible payments (74%), concierge services (70%) and real-time reimbursements (70%). In contrast, key priorities for US sponsors and CROs are real-time reimbursements (81%), data-triggered patient payments (77%) and concierge services (68%).

Insights from our 2024 Market Trends Survey highlight the current clinical trial landscape, with a unique look into how challenges and priorities differ across two major clinical research markets. From protocol complexity to participant engagement and use of technology, when it comes to conducting clinical trials, the EU and US face similar challenges but with varying nuances and views.

Regardless of the differences, it is clear that there is a shared commitment to driving efficiency and improving support for participants and sites alike. By leveraging this data, sponsors, CROs, sites and solution providers can better direct their efforts and strategies to optimise the areas where there is the greatest need. Ultimately, it is through the voice of these key stakeholders that we as an industry can enhance participant experiences, remove burdens on research sites and improve clinical trial outcomes.