Clinical trial site managers do themselves a disservice if they don’t press sponsors to consider monthly payments as opposed to the industry standard quarterly schedule, says Nikki Couturier, BSRT, CCRC, a budget and contract specialist with IACT Health.
“Sponsors are showing more willingness to work with sites on payment frequency,” Couturier says. In the past, payment schedule terms tended to be very strict, she adds.
That said, Couturier has observed something of a shift of late; sponsors have become more open to negotiating other payment terms if a site pushes back. “Don’t accept their payment rate at face value,” she suggests. A site’s price tag should reflect its own financial statement in terms of real costs in a specific situation.
Sites should also be skeptical when a sponsor says it is offering what other sites get, Couturier says. “That’s not [always] true.” While it makes sense to ask a sponsor how much time a given task or project might take, use that figure only as a starting point for your own calculations.
In the past, “we had no idea how to evaluate our costs,” Couturier says, but she worked with her team and other personnel to change that. She uses her own experiences as a Certified Clinical Research Coordinator (CCRC) to help gauge how much time a project will take. When some aspect of the work is out of her realm of experience, she goes straight to clinical staff who have a track record in that arena. Ultimately, they base their charges on a real-world hourly assessment, instead of charging by task.
Couturier has also had some success with a new wrinkle—a tiered budget. Describing it as a “huge breakthrough,” IACT has been able to negotiate deals where the site agrees to two sets of contract budget terms. Couturier explains that the second set only kicks in and allows them to charge more if they exceed enrollment goals (for example in one recent trial, $5,000 per patient), “once we’ve proved we can do it ourselves our own way.”
Couturier cautions, though, that the enrollment goals should not be forced in-house as a pressure-filled incentive, but rather more as a goal.
For additional considerations and tips for developing and building site budgets, check out Mastering Budgeting at Your Site: Building and Negotiating Clinical Trial Budgets that Make Sense.