Five Key Challenges to Site Payments

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Sites play a very critical role in Clinical Trials and it’s very important that they get paid in a  timely manner for the services they render. However, numerous surveys have shown that sites participating in studies face huge challenges related to timely payments leading to low satisfaction scores by sites on Sponsors and CROs. According to the SCRS Site Landscape survey, 66% of sites have less than 3 months operating in the bank. This indicates the level of the financial burden for the sites and would adversely impact the success of clinical trials.

The following are the five major challenges pertaining to timely and accurate Site payments and its imperative for Sponsors and CRO’s to address these to improve the overall satisfaction and drive participation of Clinical sites in the studies.

  1. Lack of collaboration
    • Sites send invoices to sponsors or CRO’s for the services they render and typically have to wait for more than 140 days for payment. These payments go through several email communications between sites and sponsors/CROs in reconciling discrepancies which not only delays payments but add to the overhead in terms of manual effort for the sites.
  2. Disconnected systems
    • Payment data are more often received and reconciled manually from discrete systems at sites, sponsors and CRO’s that are not connected or interfaced. This may lead to error-prone calculations.  Sometimes the sites might use their own software for capturing the patient visits, procedures, agreed costs etc. and transfer data into the Sponsor’s or CRO’s software leading to potential errors in the process. Status about the payments received and pending are often not shared properly and leads to miscommunication and negative impact on the relationship between sites and sponsors.
  3. Currency conversions
    • The investigator and the Clinical sites might be functioning from different regions or countries leading to the use of multiple currencies and exchange rates. Any discrepancies in exchange rates and conversion lead to inaccurate site payments.
  4. Non-standardized data formats
    • The clinical agreements and budgets are quite complex and cumbersome to create, maintain and manage with several revisions during the study duration in line with changes to the protocol. The sites and sponsors/CROs follow different budget formats along with varying codes for procedures and study tasks. This led to large efforts in reviewing payments and resultant reconciliations.
  5. Manual data capture
    • Given the high cost and effort of traditional EDC and CTMS solutions, many small to medium sized sponsors and CROs capture data on subject visits, payments, receipts and invoices in spreadsheets. Given the dynamic, complex and voluminous nature of data generated through the study lifecycle, the manual data capture process is inherently error-prone. This leads to longer cycle time in review, approval and reconciliation and in turn leads to delay in site payments.


Mythri Raghunandan

Clinical Research Specialist

Cloudbyz Inc.



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