Companies hoping to become a sponsor of choice have a lot to consider. They must think about how to improve interactions with patients, sites, CROs, and other service and equipment providers. In clinical trials, sites are one of the most important pieces of the partnering puzzle. When Bayer decided to go down the sponsor-of-choice path, there was one aspect of partnering they knew they had to get right: site payments.
I was introduced to the problem several years ago while attending my first SCRS Summit. For two days I heard site personnel voice their concerns, and none was bigger than the payments issue. Late payments, long payment cycles, and payments with no supporting documentation were an issue for most sites. Payments were a concern that had to be resolved.
Site Challenges Exist
Several companies offer solutions to fix the problem. Unfortunately, if you talk to site personnel, the payment issues that exist for sites remain largely unresolved by many of the sponsors they work with.
“Over the years, payments to clinical trial sites have been one of the top struggles that sites experience,” says Mark Ryan, VP and head of site management, Americas Region at Bayer HealthCare. “Like many pharma companies, we want to be a sponsor of choice. We partner with clinical trial sites around the world and across different therapeutic areas. There are a finite number of clinical trial sites, and the best ones get to decide which sponsors and studies they want to work with and which ones they don’t. Our goal is to make study participation better and easier for them. To do so, we knew we had to do something to move the needle on processing payments.”
Unfortunately, sites not getting paid in a timely manner was just one issue facing Bayer. Sites often still had a lot to complain about when they did finally get paid. Ironically, sometimes the inconvenience of getting paid was almost as bad as not getting paid at all.
“Sites would hate it when they received a check but had no idea what it was for,” says Ryan. “That would mean someone from the site had to spend a lot of time and effort on the phone trying to track down supporting information on the payment. I experienced a similar situation recently. I received a reimbursement check from my insurance company. The check just showed up in the mail in an envelope and didn’t explain what it was for or why I was being reimbursed. It referred me to a website if I wanted more information on the payment. That is the same issue sites experience when they get paid by their sponsor companies, and it’s an issue sponsors have to fix.”
A Simple Solution
In selecting a vendor to address the payments problem Bayer went through the usual RFP process and brought in several companies for interviews. During this process Ryan was at an industry meeting and met a clinical executive from another company that recently implemented a payments solution. Ryan engaged in multiple conversations with him about the payments solution they selected and learned what he could about how it worked and the reaction of employees and sites. That company opted to use the payments solution from DrugDev – now known as IQVIA Clinical Trial Payments – and those discussions helped sell Ryan on the product.
“I remember him saying how much he loved the solution,” says Ryan. “That led me to have conversations with other sponsor companies as well. Everyone I spoke to provided really good feedback on the product. I knew we needed a solution that provided a lot more transparency and created a better workflow process for everyone involved. I also wanted a solution that would not involve a heavy training burden for both our internal and site personnel. No one trained me on how to use my online banking system or how to shop online. I simply learned it myself. We wanted a payments solution which would also be that intuitive and easy to use.”
“The ease of use is what sold me as well,” says Geri Masessa, director of resource management for Bayer Healthcare. “When you go through a vendor selection process, everyone wants to give you their sales pitch and show you all of their features. I'm not a technical genius, so I like solutions that are easy to learn and use. Some of the other solutions we looked at seemed more difficult to use than keeping a manual Excel spreadsheet. The IQVIA Technologies’ solution worked well for us, and we are now taking the next step and linking it to our planning system that we use for budgeting and tracking. We now have live information on payments to specific sites.”
All Sites Are Not The Same
Another issue for sponsors when it comes to supporting sites is that there can’t be a one-size-fits-all approach. Not all sites are the same, so you can’t implement one solution and expect it to work for all sites and countries. There are sites that only conduct clinical trials, stand-alone clinics, academic sites, and sites that are part of a large hospital system. Bayer’s payment system accommodates all kinds of sites. When an institution is paid, those institutions can more easily see how much they should be getting paid. Masessa notes this is something they could not do in the past. Sites are also able to demonstrate how much revenue they are generating for their institutions and do so without the use of a manual and complicated spreadsheet.
“A site can track all of the details of when an invoice was paid, what was included, and see all activities along the way,” says Ryan. “If a site says they did not receive a payment, we can track it down and determine where it went and even determine the banking information associated with the payment. Sites are always able to track down the payment with the information we provide to them. That is a huge relief for both Bayer and our sites.”
The transparency feature is what Ryan likes best. It helps him to see what has and has not been paid and to view payments information in real time. It is also enabling the company to move away from hold backs, something sites are glad to see go. Those payment hold backs were 25% at one time. Ryan notes they were decreased to 10% and then 5% and have now been eliminated entirely by Bayer.
The new payments system was first rolled out in the U.S. but is now being implemented globally to achieve consistency across the payment process. Ryan notes IQVIA Technologies has knowledge of the laws and guidance that exist in specific countries or regions that they bring to the table. For example, if a third party is making a payment on Bayer’s behalf, there is a chance the company could lose tax benefits or rebates. Local laws vary from region-to-region and country-to-country. Having a partner with knowledge of those laws can save companies a lot of time, aggravation, and money.
“The whole project has been a fun and interesting ride,” adds Masessa. “We thought rolling this system out in the U.S would be a challenge. Now that we have moved forward to our global phases I have a new appreciation for how streamlined processes are in the US, as well as how complex ex-US laws and regulations can be.”
Some minor issues did arise because Bayer pays sites in local currency, rather than contracting centrally. In a couple of countries, Bayer had to develop a hybrid process because of some of the local complexities.
“We use the IQVIA Clinical Trial Payments system as much as possible to get the transparency,” adds Masessa. “The good thing about working with IQVIA Technologies is that they have the knowledge and experience and flexibility to advise us on what is possible, rather than us assuming we can’t do something. We are moving along and are now in 18 countries and continue to add new ones to the list. From a payment perspective, this solution has been life changing for us.”