Scaling Patient Recruitment Across Research Sites: A Sponsor-Focused Depression Trial Case Study

Depression, Major Depressive Disorder (MDD), MDD, Patient Recruitment, Treatment Naive Depression, Treatment Resistant Depression (TRD)

Scaling Patient Recruitment Across Research Sites: A Sponsor-Focused Depression Trial Case Study

October 30, 2024
By: Howie Levy

depression, mdd, patient recruitment, recruitment, sponsor, trd

C6 was tasked with developing a scalable performance marketing program for patient recruitment across multiple research sites conducting a depression trial. The trial sponsor was behind on their enrollments and needed a program to be flexible enough for any participating site to implement while maintaining consistent performance metrics and cost efficiency.

Initial Program Design

C6 designed a standardized recruitment model with the following parameters:
– $15,000 budget allocation per site
– $75 cost per referral billing structure
– No additional setup or fixed costs
– Target of 200 depression referrals per site

The initial forecast projected a conversion funnel with:
– 65% conversion to phone screenings
– 35% progression to pre-screenings
– 3% advancement to study screenings
– 0.5% successful randomization rate

Actual Performance Results

Over the past year, the program expanded to include more than 60 research sites, demonstrating significant scale. Key performance metrics include:

– Total budget utilized: ~$1.6M
– Average site budget: ~$25,000
– Total referrals generated: 20,964
– Phone screening conversion rate: 69%
– Pre-screening conversion rate: 51%
– Study screening rate: 1.04%
– Randomization rate: 0.4%
– Cost per randomized patient: $19,753
– Total randomized patients: 81

Site Performance Segmentation

Analysis revealed three distinct performance tiers:

**Top Tier (20 sites)**
– Highly efficient with $13,738 cost per randomized patient
– Recommended strategy: Aggressive investment and budget allocation

**Middle Tier (16 sites)**
– Moderate efficiency with $37,786 cost per randomized patient
– Recommended strategy: Maintain steady investment while monitoring maturation

**Bottom Tier (14 sites)**
– No successful randomizations
– Recommended strategy: Reduce or eliminate investment

Key Learnings and Conclusion

1. Site-level performance varies significantly and each site is unique in terms of geography, capacity and operational processes, necessitating a tiered investment approach.

2. Actual conversion rates exceeded projections for initial screening stages, but there is significant room for improvement with sites lead management pracites.

3. Final randomization rates were slightly lower than projected (0.4% vs 0.5%) mostly due to the closing of a Treatment Naive Study a heavy skew toward Treatment Resistant Depression Study.

4. Cost per randomized patient averaged $19,753, higher than initial projections but still within the sponsors acceptable range.

5. Continuous performance tracking enables dynamic budget reallocation and optimization of the sponsors marketing spend.

The C6 recruitment program demonstrated successful scalability across a large site network while maintaining reasonable cost efficiency. The segmented performance analysis provides clear guidance for budget optimization, enabling sponsors to accelerate enrollment while managing costs effectively. Ongoing performance monitoring and budget reallocation remain crucial for maximizing program effectiveness.

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