Myths, Fees, And Ethics: What You Should Know About Prepaid Debit Cards In Clinical Trials

By Sam Whitaker, Founder and CEO of Mural Health

The introduction of prepaid debit cards to clinical trials revolutionized participant payments, offering a faster and more accessible alternative to checks or cash. However, as their adoption grew, so did the reliance on fees as a revenue stream for program managers—companies that administer these card programs. Fees such as inactivity charges, monthly maintenance fees, and ATM withdrawal costs became a major source of profit, often at the expense of trial participants. A persistent myth in the industry suggests that these fees are imposed by sponsor banks, when in reality, program managers can set and benefit from these charges.

Ethically, this raises concerns about transparency and fairness in participant compensation. Institutional Review Boards (IRBs) and sponsors must take responsibility for ensuring participants receive full and fair payments. They should demand full disclosure of fees, consider alternative payment methods like direct deposits or digital wallets, and assess the impact of fees on participant retention. Mural Health offers a truly fee-free prepaid card. By prioritizing transparency and fairness, clinical trial payment solutions can evolve to better serve participants rather than profit from hidden costs.