Clinical trials are a necessity for the treatment, diagnosis and prevention of diseases, but recruiting patients to conduct them has proven to be a challenge. A 2012 quantitative study conducted by the Tufts Center for the Study of Drug Development found that 11% of investigative sites ready-to-begin recruitment failed to enrol a single patient.
Over a decade ago, clinical operations professionals used to say this value was 20% and the figure became very popular, although it had no scientific support. Even though the updated metric is much lower, it still shows that patient recruitment and retention remains a problem within the industry. This is not only bad news for the discovery and development of new drugs; it is obviously bad news for pharmaceutical companies, which allocate about two thirds of a product total development costs on clinical trials alone, according to the European Federation of Pharmaceutical Industries and Associations (EFPIA). Any delays impact a product's time-to-market by months and result in a loss of millions of dollars in revenue.
There are several methods and strategies for clinical trial recruitment, such as physician referrals and mass media advertising. However, the 21st century offers a tool that could complement others and be a great opportunity to create awareness and boost enrolment within clinical trials if used adequately and responsibly: social media.
Global social media users passed the two billion mark in 2015, which represents almost a third of the world population, according to the online agency We Are Social. Over the last 12 months this figure increased by 12% and projections show that the number will continue to grow in the following years, reaching all age groups. Facebook, Twitter and LinkedIn are some of the most popular social networks worldwide, where users share most aspects of their lives on a regular basis. Additionally, social media platforms are less expensive compared to mass media and they can be more contextually and geographically targeted.
All this means that by analysing the online activity of billions of social media users, sponsors can find the patients they need for their trials in a quicker and more precise way, as well as at a much lower cost than traditional methods. However, the industry has still not fully embraced social media platforms.
The 2014 whitepaper "Industry Usage of Social and Digital Media Communities in Clinical Research" published by the Tufts Center for the Study of Drug Development, which brought together a group of 20 pharmaceutical companies and CROs, found that social media is being used for patient recruitment on an estimated 11% of all trials with usage largely limited to the North American region.
The report also found that patient recruitment for clinical trials through social media is expected to grow, with 9 of 14 companies planning to increase adoption of social media to recruit in the US and 5 of 12 planning to do so in Western Europe. In the Asia Pacific region, sponsors and CROs report that general usage is still low, but that it is growing rapidly.
So, what is preventing pharma and biotech companies to engage more actively with social media? Ethical and regulatory concerns are the main obstacles. For example, sponsors are concerned about the research bias that could be introduced into a study by having patients using social media to communicate with others about their experiences in a clinical trial. However, these concerns could be solved by engaging more effectively with patients once they have been identified.
How can companies make the most of social media?
By analyzing social media sites, sponsors can discover where patients can be found online, what the target audience is talking about and how they are talking about a specific disease to know how to make a specific trial more attractive to potential patients. Once it has been established where patients can be found online, it is possible to place ads on the social media platforms that they visit that will direct them to a trial web page.
Another approach is to partner with advocacy groups or health pages so that ads can appear on their webpage, Facebook and Twitter page, as well as other online resources. In the US alone, one in three adults go online to figure out a medical condition, according to a 2013 national survey by the Pew Research Center's Internet & American Life Project.
As such, social media allows sponsors to advertise in a highly targeted way. Online ads are also more likely to replicate an offline experience. As people spend more and more time checking social media they may pass these links on to other people.
Identifying and engaging key bloggers and Twitter personalities who support trial participation is also an important way to raise awareness of studies and inform people about specific trials going on in their communities. It is also possible to launch Twitter campaigns to bring the trial to the attention of the right patients by using popular hashtags within the targeted population.
Some big pharmaceutical companies like Lilly, Pfizer and Novartis have already piloted or tapped into social media with good results whilst protecting potential patients' confidentiality and privacy. In 2010, a study of Facebook that ran for five months showed that an advert which invited females between the ages of 16 to 25 from Victoria, Australia to participate in a health study was clicked on by 551 women. Once they clicked on the ad, they were taken to the study's website. Of those, 426 agreed to complete a survey and 278 completed it.
To improve the use of social media for clinical trials, the whitepaper published in 2014 by the Tufts Center for the Study of Drug Development suggests to use social media within the context of, and in coordination with, other patient recruitment tactics; to identify metrics to measure success and compare the cost of randomized patients to other interventions, and to share learning points from each campaign.
The benefits of e-recruitment are huge and, as figures show, we are yet to see its full potential. The use of social media is inevitable in our everyday life and the pharmaceutical industry cannot escape its impact. With enough thought, responsibility and care, it can avoid delays and revenue-loss.