There are two sides to patient recruitment: the “push" (advertising) and the “pull" (referral management to randomization). While many companies focus a lot of effort on the push side of recruitment, the importance of the pull can often be overlooked. Yet this is where the rubber meets the road. The push encourages people to take action about their medical condition and seek out a clinical trial. But if patients are not pulled through the referral pipeline by the study sites, then any recruitment investment can end up being wasted. The pull involved in getting patients to the clinical site is by far the more difficult of the two efforts, involving a complex set of factors and a myriad of players. Timely and personable follow up with each patient, must be coupled with sponsors offering adequate financial reimbursement to study sites for patient screening and screen fails, to ensure both sites and patients remain motivated. From a patient perspective, the lack of follow through by study sites can not only be disrespectful, it may also undermine the industry’s efforts to encourage patients to seek out clinical trials. High-touch programs that effectively pull people through the referral pipeline can therefore have immense value in reducing the risk of patient frustration. A Tandem Approach Clinical trials can be completed faster and with greater levels of cost-efficiency when the push and pull sides of the recruitment process are managed in tandem rather than in isolation. The precision and flexibility that Internet advertising offers is conducive to this synergistic approach. Internet-based push strategies allow recruitment project teams to capture a wealth of real-time performance data on individual eMarketing tactics. Similarly, the data on pull-through by study sites can also be easily tracked in real time using appropriate tools. This allows project managers to fine tune eMarketing strategies in a matter of seconds, based on current performance metrics and the performance of sites, ensuring that the push is managed so that it is paced to closely match the capacity at each individual study site. This reduces the risk of losing patients on the pull side of recruitment due to lack of follow up or delayed response. E-Recruitment ePatient recruitment is here to stay. Over the past 18 months it has become progressively dominant in patient recruitment programs. Yet while the innovation of social networking sites has successfully spread around the world at an unprecedented rate, for many study sites (in the U.S. and elsewhere) the shift to ePatient recruitment has come too swiftly. The knowledge and skill set required to master the dynamics of a continuously changing online marketing environment has created a digital divide. Internet savvy companies are proactively and strategically integrating eMarketing into their patient recruitment plans during the initial phases of the study, rather than waiting for the study to require a rescue plan. The cost effectiveness of Internet advertising allows companies to avoid expensive study delays by investing minimally up front, and measuring and managing recruitment effectiveness on a daily basis. The rapid rise of Internet advertising has given companies cheaper and more convenient ways to reach their target audience than via traditional media (TV, radio, and print), reducing media costs while improving return on investment (ROI) as a result of higher response rates. The value of television, newspaper, and radio is on the decline, supplanted by the improved targeting afforded by digital advertising. Audience fragmentation is at the heart of this shift, as patients and advocacy groups continue to mobilize with unprecedented speed, using platforms such as smart phones and tablet computers, into self-selected communities determined by interests, likes and medical conditions. Clinical teams who have embraced the Internet and eMarketing as an integral part of their patient recruitment strategies have generally found online media costs to be significantly lower, with per patient recruitment costs sometimes as little as an eighth as much as offline advertising costs. With lower media costs and higher response rates, digital advertising is accelerating recruitment timelines. But it must be noted that these operational efficiencies have required fundamental changes in staffing and recruitment management. Experienced digital advertisers are replacing traditional media buyers; advocacy managers need to have social media expertise; and recruitment investment decisions must now be made on a daily rather than weekly basis. These process changes are resulting in marketing precision, with measurable gains in delivering cost efficiencies. The Science of E-Marketing Being able to understand where specific patients make their online home is at the core of a successful ePatient recruitment program. Beyond age and ethnicity, eMarketing can be more precisely matched to study site location and specific patient communities, and set up faster and more cost-effectively than was achievable with broadcast media. The plethora of analytic and competitive intelligence data has therefore turned ePatient recruitment into a science, enabling marketing precision to a level that was never before possible. MediciGlobal Clinical trials can be completed faster and with greater levels of cost-efficiency when the push and pull sides of the recruitment process are managed in tandem rather than in ­isolation. The Push and Pull of Patient Recruitment MediciGlobal is a specialty patient recruitment — retention firm and is a functional service provider. { For more information about MediciGlobal, visit mediciglobal.com.

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