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Switching to digital: why will it help clinical trials stakeholders?

The decline in R&D efficiency is one of the biggest challenges the pharmaceutical industry is facing today. The development of complex new therapies targeting smaller patient populations in a timely manner and in a competitive environment requires huge investment. As a consequence, clinical trials are changing, and the evolution to digital that is already on its way must undergo an even more important transformation in order to face these challenges. Evolution to digital will help patients, sites, and the industry.

3 drivers for increasing the use of digital technologies in clinical trials:

#1 Inability to recruit or retain subjects: In a survey carried out by the  Center for Information and Study on Clinical Research Participation (CISCRP)1, ‘study location’ and ‘visits too time consuming’ were cited by 23% and 11% clinical study participants, respectively, as their least favorite aspect of their experience.  When considering participation in a clinical study, the most important information for patients includes the potential risks and benefits (83%), but more practical aspects follow closely such as the medical procedures required and physical location of the site, suggesting that the trial burden will be a barrier to patient enrollment.

#2 Decrease in trials efficiency: despite an increase of 9%  in the total number of clinical trials in 2018 over the prior year (and 35% over the past five years), the success rate of clinical development from Phase I trials to regulatory submission fell to 11.4% in 2018 (down from 14.4% in 2017), and was below the average of 14% in the prior ten years2.

#3 Spiraling costs vs flat number of new marketed drugs: The pharmaceutical industry spent over four times more on research and development in 2015 than in 1995, with no corresponding increase in the number of drugs approved by the FDA.

Digital solutions are changing the way industry handles and manages clinical data

The emergence of digital tools having the ability to directly handle vast quantities of data are transforming the use we make of the physiological and biological signal.

Indeed, biological and physiological data captured by connected devices will directly provide the key essence that makes the clinical trial successful. Not having to rely on heavy site logistics and a large number of systems, nor going through the challenges and costs linked to data verification, data cleaning, and data transfer activities will be a game-changer in the very near future.

Combining data from multiple sensors and devices with ePRO can create a large, complex data set that is beyond the current capacity of standard electronic data capture systems (EDCs).

In an ICON survey on ‘Improving Pharma R&D’, the Big Data, AI/Predictive Analytics and mhealth’ were cited by respondents as “the disruptive technology trends which will have the greatest impact on clinical trial operations”3

 

Electronic data capture and connected devices enable patient-centric trial designs

Using digital solutions such as eCOA and connected devices in clinical trials, as well as implementing new generation site-less trials, will tremendously reduce the burden for patients.

  • Decreasing the visit burden: totally site-less trials or reduced on-site visit schedules will grow with direct data capture; patients will be able to remain in their own home while their biometric data are transferred, reducing or eliminating the need for patients to travel to a study site. If site visits are needed due to requirements for specialist equipment or specific therapies, the use of digital technology has the potential to reduce the length of the site visit – this is helpful for patients with impaired quality of life such as severely ill cancer patients or pediatric populations.
  • Connected devices will facilitate data provision via direct data streams: discrete and continuous data can be easily captured and quickly transmitted via integrated systems, reducing the demand for patients.
  • Increasing eCOA and e-diaries use in clinical trials, even for primary endpoint measures, will make it easier for patients to provide data and complete their questionnaires/diaries at their own time in a user-friendly fashion.

 

Electronic data collection and monitoring will streamline sites’ operating processes

 The digital solutions implemented in clinical trials will not only reduce the burden for patients but will also have a positive impact at the clinical sites.

  • Reducing the technical and procedural burden at the site level will be possible thanks to integrated data capture and transfer. Also, the numerous activities dedicated to study set-up and the maintenance of multiple systems at a study site will be managed by the devices and e-data collection manufacturers.
  • The current burden of monitoring, not only for sponsors and CROs but also for site staff, will also be alleviated with remote monitoring, risk-based monitoring (RBM) and direct clinical data review and reconciliation that are facilitated by electronic solutions.
  • Decreasing the number of visits and/or the time spent on site will free up time that site staff will be able to allocate to other activities.

 

The industry is still paving the way towards the digital transformation of clinical trials. Embracing the digital evolution means much more than investing in and implementing new tools and systems: a greater degree of sophistication is required. The successful roll-out of the new generation clinical trial requires new expectations to be well understood and the skillset of both the study teams and the site staff to shift. Clinical science in the 21st century will require a flexible operational model and experienced study teams that understand patient needs, listen to site requirements, and have developed expertise in electronic device logistics and handling.

 Estelle Haenel, Medical Director @ Kayentis

 

See “how can digital innovation turn clinical trials into a positive patient and site experience”:

References
[1] https://ciscrp.wpengine.com/services/research-services/public-and-patient-perceptions-insights-study/
[2] https://www.iqvia.com/insights/the-iqvia-institute/reports/the-changing-landscape-of-research-and-development
[3] https://www.iconplc.com/insights/blog/2018/05/18/the-power-of-ai-to-transform-clinical-trials/index.xml

Last update : 19 November 2019

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