A Patient’s Perspective – How Antidote is Digitalizing Clinical Trial Patient Recruitment in the US
One of the primary cost drivers for pharmaceutical and biotech companies bringing drugs to market is patient recruitment and enrollment in clinical trials. Patient recruitment represents >30% of clinical trial costs . In oncology specifically, 40% of all trials and 71% of phase III trials fail to recruit the targeted number of patients, delaying drug approvals and limiting patient access to trials, often during late-stage disease when patients have exhausted other care options .
Clinical trial patient matching historically has occurred with the use of contract resource organizations (CROs), typically private entities that pharmaceutical clients contract with to outsource management of clinical trials. By 2020, an estimated 70% of all clinical trials will be conducted by CROs. Despite the benefits of an external specialized workforce, CROs can be bureaucratic which often results in delays in drug development and rising costs . Startups are emerging using digital solutions to replace a step in the CRO supply chain and more efficiently match patients to relevant trials. One tech company with a unique approach to clinical trial patient supply management is Antidote, a digital health startup with the mission to better connect patients to clinical trials.
Why Antidote’s mission?
A number of tech companies are trying to digitalize clinical trial matching, and most are approaching the problem by working with pharmaceutical companies to recruit for specific trials. For example, IBM Watson for Clinical Trial Matching uses artificial intelligence to scan patient electronic health record documents and match patient characteristics to trial inclusion criteria . The supply-focused approach to clinical trial matching is important in expediting patient enrollment and facilitating drug development but it is not a solution for patients.
Antidote is filling the demand-side gap, arming patients and families looking to play an active role in care selection with information and an easy-to-use digital solution. Antidote’s primary goal is to fill the recruitment gap for trials forced to shut down prematurely due to an inability to find enough participants . Antidote is streamlining information-gathering so patients can more easily search for and identify trials that match their disease specifics.
How is Antidote positioned to deliver value?
Antidote built a platform, Match, on which patients can answer simple questions about their condition and other health issues and see matching trials in their region. Antidote has partnered with 180+ patient advocacy groups (i.e., Lung Cancer Alliance, Patient Power) which embed Match on their websites so patients have easy access to the resource. Antidote developed additional tools such as Antidote Bridge which provides additional information such as financial compensation and placebo use, all information historically challenging to find due to CRO privacy .
In the next 2 years, Antidote is focusing on building out additional patient advocacy partnerships. Advocacy groups are strong avenues toward connecting with and educating patients but I think Antidote should also consider other direct-to-consumer marketing strategies to bolster patient awareness. Many patients do not know to ask about treatment options via clinical trials. For example, in a recent study of cancer patients, 80% of participants reported that they did not realize they had an option of clinical trials . Media advertising is one of the primary ways patients learn about clinical trials, specifically for rural and inner-city patients who are historically underrepresented in clinical trials . Antidote should further leverage media advertising to educate more patients about the option of clinical trials and empower them to use Match as a resource to evaluate potential experimental treatments.
In the longer-term, Antidote is working to link supply and demand of clinical trials. Information accessibility for patients is an important mission but Antidote is working on a SaaS that allows trial research sites to see which patients demonstrate potential eligibility so the research site can reach out directly to enroll those patients . Additionally, I think Antidote should partner with some of the technologies like Watson to link patient enrollment supply and demand to streamline supply chain efficiencies.
Looking forward – key challenges to consider
Given the competition in this space, how can Antidote ensure its solution is complementary to supply-side models (like Watson for Clinical Trial Matching)? Pharmaceutical companies are incentivized to pump money into Watson to fill their trials as quickly as possible but how can Antidote ensure its patient-empowering niche remains?
How should companies balance patient accessibility to clinical trials in more common tumor types where there may be more patients eligible for clinical trials than can be enrolled (i.e., stage IV lung cancer or melanoma)? Right now, patient demand is limited by the fact that is challenging, costly and time consuming for patients to be enrolled in clinical trials. If trials are made more accessible, what is the role of pharma companies, regulators, and patient advocacy groups in balancing supply and demand?
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