The rise of decentralised and hybrid clinical trials has transformed how life sciences organisations recruit and engage participants.
By allowing patients to participate remotely, reducing the need for travel and widening access to underrepresented groups, these models are helping researchers reach participants who may previously have been excluded from clinical research altogether.
But while much of the industry’s focus has been on recruitment, keeping participants engaged from enrolment through to completion is becoming increasingly difficult, particularly for organisations running global trials.
The overlooked key to participant engagement
In clinical trials, participants may be asked to attend appointments, submit information remotely, use digital monitoring tools or complete regular assessments over extended periods of time. Each interaction contributes to their overall experience of the study.
Yet one important aspect of that experience is often overlooked: reimbursement and compensation.
For many participants, reimbursement is more than an administrative process. It may cover travel expenses, time away from work, childcare or other costs associated with participating in a study. In some cases, compensation may even be a key factor in a participant’s decision to enrol in the first place.
When those payments are delayed, inaccurate or difficult to track, they create friction at exactly the point researchers are working hardest to keep participants engaged.
The operational challenge hiding behind participant payments
At first glance, participant reimbursement looks straightforward. In reality, it can be a far more complex process, one that leads to errors and a loss of participant trust if not done well.
Today’s clinical trials frequently span multiple countries and involve hundreds or even thousands of participants. Each participant may need to be paid in a different currency, through different payment methods and under different regulatory requirements. Crucially, research organisations must verify participant details, manage tax and regulatory obligations, ensure payments reach the correct recipients and maintain accurate records throughout the process. And as studies become larger and more geographically distributed, those requirements multiply.
What begins as a simple reimbursement can quickly become a significant operational undertaking.
For many organisations, that process is still managed through disconnected systems and manual reviews. While this may be manageable at smaller volumes, it becomes much harder to sustain as studies scale.
The result is administrative complexity that grows at precisely the moment organisations need to focus on participant engagement and study delivery.
Why trust matters more in decentralised research
The shift towards decentralised trials has introduced many benefits, but it has also changed the relationship between participants and research organisations.
In traditional site-based trials, participants often had regular face-to-face interactions with study teams. Questions could be answered quickly, and issues could be resolved in person.
Remote and hybrid models naturally reduce some of those touchpoints.
As a result, trust increasingly depends on the quality of the overall participant experience. Participants need confidence that communications are secure, clear and accurate, and that commitments made by the study will be honoured.
Payments play a surprisingly important role in that experience.
A delayed reimbursement may seem like a minor operational issue from the perspective of a study sponsor. For a participant, however, it can feel very different. It may create uncertainty about whether expenses have been approved, whether information has been received correctly or whether the organisation is managing the study effectively.
Over time, these experiences can influence how participants view the research process and their willingness to remain engaged. And it’s not a hypothetical risk. Global payments research commissioned by Tipalti found that 26% of companies lost contributors in the past 12 months due to payout-related issues. Among those companies, delayed payments were the most common cause (52%).
Why payment errors carry more risk in decentralised trials
Alongside participant experience, organisations are also navigating growing operational and compliance challenges.
As studies become more global, researchers face increasing pressure to verify participant identities, prevent duplicate payments and ensure funds are distributed accurately across multiple jurisdictions.
Errors can have consequences beyond administrative inconvenience. Incorrect payments create additional workloads for research teams, while inconsistent processes can introduce compliance issues and increase scrutiny around financial controls.
These risks are particularly pronounced in decentralised studies, where participants are more geographically dispersed and often interact with research teams primarily through digital channels.
For many organisations, this is driving a broader reassessment of how participant payments are managed, not only to reduce risk but to protect the participant relationship.
Supporting clinical trials retention through better operations
Improving participant retention is often discussed in terms of engagement programmes and study design. And of course, those factors will always be important.
But participant experience is also shaped by many smaller interactions throughout the research journey, including how reimbursements and compensation are handled.
As clinical trials continue to become more global and decentralised, participant payments can no longer be treated as a purely administrative task. They are increasingly part of the broader participant experience and, by extension, part of how trust is built between participants and research teams.
The organisations that manage this most successfully will be those that recognise that operational excellence and participant experience are closely connected. When participants are paid accurately and on time, and feel supported and informed throughout a study, they are far more likely to remain engaged until the very end.
By Rob Israch, President at Tipalti
