During the thick of the COVID-19 pandemic, not every country around the world had the same experience. Some nations saw high infection rates and numbers of fatalities; others (including Australia and New Zealand) were relatively low.
Courtney Valeo, senior principal consultant with patient services tech specialist Greenphire, talked to Outsourcing-Pharma about how Australia and New Zealand weathered COVID-19, and why the nations’ experience during the pandemic is impacting how pharma firms and their research partners are viewing the regions.
OSP: Australia and New Zealand COVID-19 infection and death rates remained relatively low through the pandemic. Can you provide any perspective as to why this was the case?
CV: Now that we’re hopefully in the later stages of the pandemic, it is interesting to analyze the impact of the disease across the globe. In the case of Australia and New Zealand, many might attribute the success in curbing the spread of COVID-19 to the isolated geography of the island nations.
However, it was the quick response to the pandemic by their governments that kept both infection and death rates relatively low. The two countries’ governments were quick to shut down their borders and mandated quarantine for any returning citizens as to not contribute to community spread. They also put extensive testing and contact tracing in place.
Similarly, they’ve taken a measured approach to opening up the country. In April, it was announced that the residents of Australia and NZ could travel between the two countries without quarantining.
The countries maintain a zero-tolerance approach to COVID. When an outbreak occurs, as did in the city of Perth on April 24th, the response is “swift and severe: mass testing, sudden lockdowns , and closed borders.”
OSP: How has this helped attract attention and interest from clinical trial sites and sponsors?
CV: Clinical trial sponsors have historically looked to Australia to conduct clinical trials, given its robust strong health system and world-class research community. Cancer incidence rates are notable in the area, with relatively high incidence of melanoma in ANZ (11 times the world average).
However, the Australian government has organized efforts to further position the country as an attractive locale for all types of clinical research, in part due to their low COVID-19 infection rates. Research Australia is a coordinated effort to demonstrate Australia’s high-quality clinical trial capacity to the world. They are one of the first countries to demonstrate a country-level approach for decentralization, funding, staffing, and more.
The approach may be working. The market used to be known for its early phase capabilities, but increasingly sponsors and CROs are following through with studies of the next phase, saving both time and money.
Not to be overlooked, New Zealand is an attractive location for various reasons as well, notably its history of meeting recruitment and retention targets, along with its straightforward regulatory approval process. Sites in NZ were more easily able to reopen and (with some small process and technology changes) essentially operate under pre-COVID business-as-usual conditions.
OSP: Please tell us onhow the trial “traffic” in Australia and NZ has shifted since the pandemic began. Are we seeing new trials being launched there at an elevated rate, or are ongoing studies being relocated to those countries?
CV: Clinical trial traffic to Australia and New Zealand has been steadily growing in recent years, however, despite the pandemic, growth persisted. In Australia, there was a 17% increase in clinical trials from July-December 2020. New Zealand has seen somewhat slower growth, but it is anticipated to ramp up soon. According to Pharmaceutical Solutions, an ANZ clinical trial recruitment agency, they have seen a 90% increase in inquiries for clinical trials since December 2020, the highest volume the company has seen in 10 years.
Interestingly, the focus has not solely been on COVID vaccine development; there has been an increase in all therapeutic areas.
OSP: For the trials that are being started or relocated, how is that movement impacting patient recruitment, engagement , and burden? Are patients or potential recruits being asked to travel further than they otherwise might have?
CV: While international travel may not be back to pre-COVID-19 levels, ANZ clinical trial participants can visit hospitals and research sites for study appointments largely without fear of contracting COVID-19. That said, Australia is a rather large country. When traveling for a clinical study, a participant may need multiple mechanisms to get to a visit, and having one itinerary that accommodates all travel needs, whether ferry, flight, car, or train, can be incredibly beneficial.
OSP: How is Greenphire helping deal with the impact associated with the influx of trials to these countries?
CV: To deliver on global recruitment and retention goals, we are increasingly seeing sponsors and CROs work with Greenphire to provide comprehensive patient convenience services that can accommodate multiple transportation methods across all their studies and geographic regions.
Moving into the second quarter of 2021, there was a dramatic 75% increase in the booking of Australian travel itineraries using the Greenphire ConneX travel service from just three months prior.
Sponsors and CROs are also looking to remove the financial burden on patients, encourage broad participation in their studies and relieve sites of burdensome paperwork. We are working with nearly 500 clinical research sites in Australia today, and more than 1,000 patients enrolled.
Looking back to nearly a year ago, the Australian market was the first to adopt our ConneX Patient Direct service, a COVID-19 response that delivered medicines and study personnel right to the participant’s home. The Australian research community continues to look for ways to engage patients and deliver on innovation.
OSP: For trial teams looking to focus recruitment on potential populations within the countries’ borders—how diverse are the patient pools there? Are there any particular benefits (or challenges) to recruiting there?
CV: Approximately 28% of the Australian population is from a “culturally and linguistically diverse backgrounds.” However, their involvement in clinical research is not at this level and as a result, can have an impact on the medicine and dosing available for different ethnic populations. Lillian Leigh participated in a clinical trial during which, she discovered that she was taking double the dose of what she actually needed as a Southeast Asian person.
Factors such as access, cultural and language barriers exacerbate the problems for CALD communities but can be overcome. Education is crucial, but so is providing multi-lingual documents and patient engagement platforms, including reimbursement and transportation.
OSP: I notice you’ll be participating in the Society for Clinical Research Sites Site Solutions Summit—can you tell me a little bit about the event, especially why Greenphire will be there, sessions you plan to present at, connections you hope to make, etc.?
CV: Greenphire is a strong supporter of the SCRS and we’ve participated in their annual Asian-Pacific Solution Summit for the last few years. This year (despite the event being virtual) we look forward to connecting with sites, sponsors and CROs, to understand the trends and challenges in the region.
In addition to delivering services within Australia, we also look to the region for user feedback. In 2019, we hosted an in-person user forum with sites. During this session, we were able to educate sites and receive input from them on ways to improve.
I am always excited when I’m able to go back to that group and update them on enhancements made to our products as a direct result of their response. This and other events reconfirm our commitment to innovating based on live user feedback.