He joined the company five years ago where he continues to work on recruitment pain points within clinical trials. OSP caught up with him at DPharm in Boston to find out how the company is developing and to talk about new initiatives and a brand change.
Could you tell me a little about Trialbee?
We help find the patients to get enrolled in trials, we find new referrals and we help manage them through to the trial sites.
At the core of this strategy, we have a software platform called Trialbee Honey. If you see an advertisement for a trial or if somebody emails you about one, there's usually a click or a link, but you have to do something to go and learn more, like click a link in the email and that will take you into our platform. Once the patient comes, they see information about the study and if they are interested, they click to see if they qualify, and then we have a way to screen them. They answer some questions on the web page, usually five or 10 questions at most - basic age, gender, diagnosis, what prescriptions they are on, and some more simple questions.
If they are eligible at that point, we then put them in a global call center of nurses. We cover 24 countries today, and we can operate in up to 48, but most of the trials come back to the same countries over and over. We have staff in 24 countries that monitor Honey for this flow of patients, and we have a call center interface for them. So, when they see a patient come into their queue, they immediately reach out through the platform, you can do text or you can do email, and the goal is to reach the patient via a phone or video call to then do a deeper pre-qualification of that patient.
We'll ask them questions about more criteria in the protocol that we couldn't just ask them on a simple web page. We try to screen them well. And then if they pass that interview, and they're still qualified for the study, we move them to the site. So, sites are also logging into Honey. So now you have the patient going through, and you have the call center logging in. Now the site logs in and they have a queue, and the patient shows up in their queue. And they reach out and speak to the patient and try to schedule them for a first office visit.
That's the workflow.
So how do you first get the patients engaging in the first place?
We do that through digital marketing. We use real-world data to put out digital ads in all these countries. But we have a set of partners we call omni-channel partners. Some of those have a pool or a database of patients that they then reach out to, and we bring those partners into our studies.
When we're doing outreach, it's our digital marketing. It could be an online disease community, like Inspire that has a community built around the specific indication so they let their community know if you're interested in this trial, this trial, click here. We have partners like Evernorth that do pharmacy, and mail order pharmacy and they can send out to their subscriber base and say we have a trial and see if they are interested. So, these partners have different ways of reaching out to the patients at the front end.
Because all that's going through one platform, that workflow, we can derive good analytics from it and that's where the sponsors log in. So, the pharmaceutical companies when they log in, they see this whole flow of global patients, at each step in the process, and how long it is taking at each step. You know, how long are patients waiting for the call center or waiting for the site to follow up? They will see the research sites, how quickly they are grabbing the patients and scheduling the first office visit, moving them to consent or rejecting the patient if they fail a screening at the site. Sponsors drive a lot of value from those analytics.
We have digital marketing and global project management capabilities to run these studies. And then we have the partners handle those three things.
You obviously must have to pay close attention to guidelines.
Yes, we do to regulatory guidelines, including what ads we can place in what countries, what things we can say, etc. Everything we put in front of a patient, whether it's a question in that process, or whether it's an advertisement, it must go through ethics approval in each country. So, when we start, before we can launch we have to build those materials. We must translate them into all the languages, and we must submit them to all the local ethics authorities in each country - to adhere to the end. Some countries allow you to use Facebook for this, some countries don’t allow you to use it. So yeah, it gets complicated from the regulations' perspective.
If you’re struggling to get the diversity, do you have people that can go out into the communities you’re trying to target?
That's right. We have community partners Acclinate for our diversity work and diversity partnership. They go into the community, they build up awareness and health literacy, and then they offer trials. When we receive a study to work on, we try to map the patient's typical journey and from that map we can determine where they're most likely to learn about a study, whether it's a student prescription provider, whether it's through their online behavior, with the younger demographics, they might be on TikTok. Older demographics might be on Facebook. That’s how we build our strategy of how we're going to do ads, and which partners make the most sense. By somebody's prescriptions, you can work out what diseases they might likely have. We can tell our pharmacy partners, if you have patients on this prescription, please let them know about this trial. And so, we never reach the patients directly. We're not allowed to know who they are.
Have you hit any bumps in the road and if so, what have you learned from that?
We have learned a lot. It's been inefficient how recruitment has worked and I think one of the biggest barriers is when you're bringing something novel or innovative, you have to do it in a way that doesn't disrupt too quickly. You must show that you understand the regulatory frameworks. You can't just have the technology you have to surround it with people who know how to do global recruitment of patients.
And so I think one of the lessons we've had is to be patient and introduce newer innovations in a way that the large pharmaceutical companies can handle within their change management framework because they can't just change overnight the way that they were doing it yesterday.
It is the number one challenge. Then I think there are learnings internally, we have employees in nine countries but only one office in Sweden and we do all our product development engineering, our people in talent or finance and they are all in Sweden, but that's about 30% of the company. The rest of it is remote in eight other countries. So, there have been lessons on the management side, like how do you manage that in a virtual world and build a good culture?
With about a third of our employees out of that office in Sweden, about a third in the UK market, that's most of our delivery team. Most of it is centered in the UK market. And then about a third up and down the East Coast here in the US. We have one or two employees in other countries in Bulgaria and South Africa.
Have you had any recent developments you’d like to share with us?
Last month, we launched what we call a rescue kit. What we do is on a big scale, and it takes a long time to set it all up, get the regulatory approvals, and also get the translations, etc. Our customers typically bring us in as they're planning the study.
Well, what happens if they don’t and they're in a study and halfway through enrollment and they realize it is not going well, we're going to have to either extend the last patient in the timeline or add more sites. Now we have the rescue kits as they help rescue a study that's behind on enrollment.
We can take that whole infrastructure, and we can consolidate it down to a startup time in as little as four weeks. So, from the moment you engage us to as little as four weeks later, you can be launching into your markets. Now we can't control regulatory turnaround timelines on ethics, so sometimes it's longer than four, but so far it has been pretty good so that's new and we call that the Trialbee rescue kit. We think that's going to be beneficial, like a fast startup, to try and turn things around.
Then at DPharm, we've launched a whole new brand. The company was blue and white, they had been our colors. Our messaging has been around matching, enrolling, and engaging since I joined three years ago. For three years we've been building this newer strategy that's platform-based partner ecosystem-based, and more global. And we thought it was time to align our identity in the market with where we're at today. So, the new brand is warmer, it's orange and black colors. The logo has now been changed but there’s more behind that. We're talking about ourselves the way we are today, in terms of the platform, in terms of the global digital recruitment capabilities, finding patients, and in terms of the partnerships that we're building up within this ecosystem. We feel very happy with where we are.