IQVIA's participant payments: Streamlining clinical trial payments for global compliance

By Liza Laws

- Last updated on GMT

© Getty Images
© Getty Images

Related tags Clinical trial Clinical research Patient centricity Pharmaceutical industry

OSP recently had the opportunity to sit down with Jim DiCesare, senior director of Americas operations at IQVIA, to discuss their innovative participant payments service.

IQVIA recognized the intricate challenges associated with participant payments in clinical trials, which often involve cumbersome processes and multiple vendors, leading to delays and dissatisfaction among participants. Jim provides insights into the motivations and objectives behind launching this comprehensive solution.

Can you explain the core motivations behind launching IQVIA's participant payments service?

IQVIA recognized the complex challenges of participant payments in clinical trials, impacting participants, sites and sponsors. Traditional approaches involved cumbersome processes, multiple vendors and inconsistent payment methods, leading to delays and dissatisfaction among participants. Sites carried the majority of the burden of facilitating payments, which detracted their focus from improving clinical trial efficiency and optimization. Congruently, sponsors encountered difficulties ensuring compliance within expanding regulatory requirements across various countries. As clinical trials continued to expand in scale and complexity, IQVIA recognized the need for a globally compliant payment solution that streamlined the payment processes.
To address these challenges, IQVIA developed Participant Payments, a comprehensive solution designed to address the complexities of clinical trials by streamlining processes, reducing administrative burdens and ensuring global regulatory compliance. It offers a valuable tool for all stakeholders in clinical trials.

How does the new participant payments service democratize access to clinical trials and life-saving treatments?

IQVIA’s Participant Payments democratizes access to clinical trials by removing financial barriers to clinical trial participation. Currently, due to delays in stipend and expense reimbursement processing, participants are often responsible for payments made to accommodate clinical trial participation. This includes fronting the payment for a range of transportation, accommodations and provisions needed for participants to travel long distances to participate in clinical trials. At the same time, participants may be taking time off work to partake in clinical trials. All these factors act as deterrents to participation, especially to those who may be in lower income groups, as fronting the costs of participation may stretch their budgets too thin. Removing these barriers and providing instant access to stipends and micro-payments, and more timely access to reimbursement payments, democratizes access to clinical trials as it enables participants of all socioeconomic statuses to join trials without fear of financial burden.

Can you elaborate on the types of payment options available through IQVIA participant payments and how they cater to diverse demographics?

IQVIA Participant Payments solution provides a simple and intuitive way for participants to receive a variety of payments, from expense reimbursement and stipends to micro-payments for milestone activities. As a truly global solution, we offer a range of payout options to provide flexibility to the trial participant, so they can opt for a method most convenient to their circumstances. Although payout options differ per country, IQVIA's Participant Payments solution will always offer a banked and an unbanked option.

Main payout options include digital Visa cards, push to debit transactions, wallet payments, ACH and cash pick-up, but other local methods such as PIX are available if required.

Digital Visa cards provide an elegant solution as they are accepted globally, and provide greater security from fraud, than older physical cards. They are also a cost-effective payout method with issuance, loading and tokenization a fraction of the cost.

What are the primary financial barriers that inhibit participation in clinical trials, and how does IQVIA’s service address these issues?
Financial burdens and uncertainties are major deterrents to clinical trial participation. Primarily, participants are skeptical that clinical trial financial payments and reimbursements will be commensurate and will arrive on time. This acts as a significant deterrent to participation as individuals do not feel the payment process is reliable or accurate. Additionally, concerns exist regarding compensation for other indirect factors, such as time off work, transportation coverage and childcare costs. These financial burdens disproportionately affect participants of lower socioeconomic status, discouraging participation from these individuals. IQVIA’s solution tackles these issues by offering timely, accessible and customizable payment options. By providing a variety of payment options, real-time access through a mobile or web application and direct-to-patient processing, our solution aims to address these financial barriers.

Figures from the National Cancer Institute indicate a significant disparity in trial participation based on household income. How does your new service aim to bridge this gap?

Several studies have found that across clinical trials, participants of lower socioeconomic status are less likely to participate in research than higher socioeconomic status participants. Financial barriers are consistently cited as a top contributor to decreasing rates of participation and retention of low-income groups across clinical trials.
IQVIA’s Participant Payments solution bridges this gap by offering flexible and immediate payments to participants. Similarly, by providing a myriad of payment options, such as direct bank transfers, virtual cards and options for digital wallets, participants can select a payment method that is most suitable for their financial needs. The solution aims to ensure that financial barriers do not act as a deterrent to clinical trial participation.

Can you discuss the importance of diversity in clinical trials and how financial inclusivity plays a role in achieving it?

Research consistently demonstrates that clinical trials are failing to reach diversity metrics. Increasing inclusivity, especially financial inclusivity, is critical to improving diversity in clinical research. Flexible payment methods are essential to accommodate the diverse preferences and financial infrastructures across different regions. Offering timely, accessible and accurate payments to participants of all backgrounds is a key component to achieving diversity in clinical research.

Traditional payment methods like paper checks and wire transfers have been described as restrictive. Can you explain why these methods are inadequate for many potential participants?

Existing methods of clinical trial participation reimbursement, such as traditional paper checks, wire transfers, reloadable gift cards and debit cards often result in retroactive payments. These cumbersome and inefficient methods lead to delays in payments, creating dissatisfaction among participants, and potentially impacting enrollment and retention rates. Additionally, participants are increasingly travelling further distances to receive treatment and participate in clinical research. To accommodate the research, participants often are required to pay for transportation, lodging and provisions to travel and enable participation. Many participants require timely and reliable payments in order to cover these extraneous expenses. Providing instantly accessible funds is critical to ensuring participant recruitment and retention in clinical trials. Additionally, physical cards are costly to create and maintain. They can also be prone to loss or damage requiring them to be replaced. Costs are also traditionally passed on to the participant if there is a period of inactivity, up to removing the entire balance from the card, which penalizes the patient.

How does the integration of virtual debit cards, stipends, and micro-payments improve the clinical trial experience for participants?

By integrating virtual debit cards, stipends and micro-payments, IQVIA’s Participant Payments solution simplifies and streamlines the process. Unlike other systems, IQVIA’s solution provides direct payments to participants via a user-friendly application accessible on smart devices and the web. Participants can easily submit expense claims, which are promptly processed, validated and paid out through multiple options. Providing immediate, accurate payments for clinical trial participation improves participant satisfaction and retention.

Can you describe the functionality of the mobile app provided by IQVIA for submitting expenses and receiving payments?

The IQVIA Participant Payments solution includes user-friendly technology designed to accommodate all participants. The intuitive solution includes a free smart device or web-based application that enables participants to receive stipend and micro-payments in real-time. The mobile application provides an easy-to-use method for participants to scan-to-upload receipts for various expenses. The solution also includes a dedicated, multi-lingual support team and site assistance to aid participants without access to the internet or the application.

How does the new service enhance the efficiency of clinical trial operations from the perspective of trial sites and sponsors?
Current participant payment challenges impact both sites and sponsors significantly. Our research indicates that a significant majority of participant payments are managed directly by sites. This responsibility involves handling complex payment processes, which can result in delays and inefficiencies, negatively affecting both participants and site financial operations. In current operations, sites are heavily involved in the administration and allocation of participant payments. This adds undue staff burden and additional ancillary costs to support the payment process. As sites handle the participant payment workflow, they are also held liable for the secure storage of payment cards and maintenance of access to financial systems.
By outsourcing the entire participant payment process to a secure, seamless solution, sites can eliminate additional administrative tasks and focus on more strategic clinical activities as opposed to participant payment disbursement. Our solution improves clinical efficiency by streamlining operations with a single, integrated solution for participant payments.
  
Sponsors currently struggle with navigating the complexities of global requirements for participant payments. Sponsors must navigate varied regulatory environments, manage multiple currencies and ensure compliance with diverse local tax laws, which many organizations are not equipped to handle efficiently. Addressing these challenges requires a comprehensive solution that integrates people, process and technology to ensure a seamless and secure payment experience for all stakeholders.

The IQVIA Participant Payments solution consolidates payments within a single vendor, enhancing convenience and reducing complexity at a global scale. Sponsors also benefit from increased participant retention as clinical trials expand across the globe. Leveraging a participant-centric payment solution improves recruitment and retention, ensuring trial continuity. Ensuring participant retention and recruitment is a significant financial benefit for sponsors, as each participant attrition can risk trial continuation and success.

What are some of the common pain points in the current reimbursement process that your service aims to eliminate?

As sites are currently responsible for the payment and reimbursement process in clinical trials, this places an unnecessary step and undue burden on the site teams. The administrative burden alone in implementing and maintaining participant payments systems at sites requires the site to carry additional resources to provide these services. Additionally, if sites are limited in their cash reserves, they may have to delay payment to participants if the site is not provided timely funding for them.  Several additional challenges affect payment operations. First, participants are required to initiate the invoicing process in order to receive their payments, however participants often lack a streamlined and standardized method for submitting invoices to the site. Second, the currently available methods for disbursing payments are restricted to reloadable gift cards, reloadable debit cards, traditional paper checks and wire transfers. These options may not always provide participants with timely or convenient payments. Our solution provides a direct to participant option that alleviates these complexities and limited payment options. While this solution eliminates pain points for participants, it also alleviates burden for sites as it outsources the entire payments process.

How does IQVIA ensure the security and privacy of participants' financial and personal information within this new payment system?

IQVIA prioritizes the security of participant data through several measures. First, the system requires minimal patient information to process payments and utilizes point-of-entry encryption to protect sensitive data. Additionally, personally identifiable information on receipts is redacted, and all sensitive data is tokenized by third-party encryption services. Finally, data is retained within the region of origination to comply with local privacy laws, further ensuring robust data protection. 

Looking ahead, how do you see the landscape of participant payments evolving in the clinical trial industry, and what role will IQVIA play in that evolution?

The financial landscape of clinical trials is evolving and complex. Clinical research faces a challenging phase with high turnover, staffing shortages, increased operational costs and inflationary pressures. These unfolding dynamics present a complex budgeting scenario. Staffing shortages and high turnover necessitate higher budget allocations for recruitment, training, and potentially higher salaries to retain skilled staff. Inflationary pressures further strain finances, escalating the costs of essential supplies and other operational expenditures. IQVIA aims to streamline the entire clinical trial budgeting process, avoiding standard-of-care over-payment and maximizing funding opportunities. Market pressures and changing clinical trial landscapes necessitate an end-to-end approach to trial financial management, from budgeting to forecasting and site payments to participant payments.
IQVIA also aims to improve forecasting by improving site payments across the globe to optimize cashflow and reduce burden on clinical operations and finance teams. As a part of this greater ecosystem, IQVIA’s Participant Payments aims to simplify the reimbursement process, reduce payment delays and increase participant retention. Creating a more streamlined and efficient payment process will lead to improved budgeting and financial outcomes for clinical research. 

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