The State Of Customer Experience In The Pharmaceutical Industry, 2022: Clinical Trial Sites

Executive Summary

Interactions between clinical research staff and pharma companies are important, as they affect research quality and the recruitment and retention of participants throughout the course of a clinical trial. Research staff has certain expectations about conducting trials, and it’s important for pharma firms to clarify and manage these. To find out how the industry is doing, we asked more than 300 trial sites how well the pharma firms sponsoring their trial met these expectations. We found that sponsors don’t meet all of the expectations research staff has of them; trial sites rated their experiences with pharma sponsors as only “fair”. Pharma needs to change its view of clinical sites: looking at them as customers will open up an array of opportunities to improve operational efficiency and boost recruitment and adherence.

Pharma Must Master The Experiences it Provides Clinical Research Staff

Clinical trial sites, which interact directly with patients and participants, are key to successful trial execution. Clinical research staff such as investigators and physicians are responsible for a range of crucial activities including collecting data; recruiting patients; gaining informed consent; providing medical support; ensuring patient safety; adhering to study protocols; and reporting adverse events. Sites invest considerable time and resources in these activities, which they must weigh against the benefits of working on industry-funded trials. Currently, many won’t make that tradeoff: half of the investigator sites that participate in industry-funded trials don’t want to do it again. High-performing sites that recruit well, keep participants safe, and boast high completion rates are rare, and pharma companies are competing to collaborate with them. Pharma firms that understand and manage these activities as a holistic customer experience (CX) reap a range of business advantages, including:

  • Faster trial completion. Operational burdens include complex administrative and regulatory requirements, the need to train research staff, and expectations about digitizing aspects of the participant experience, which can require enhancing IT infrastructure. For a site to deliver excellent experiences, it must also have adequate financial resources, provide IT and technical support, answer queries rapidly, and deliver the necessary data with maximum efficiency. A sponsor that can reduce a clinical site’s overall burden and be flexible about its standard operating procedures will help accelerate trial execution and the on-time delivery of patient data.
  • Improved participant recruitment and retention (and lower costs). Improving the interactions between sponsors and sites has a positive impact on clinical trial participants: the better prepared and equipped a site is, the better the safety and medical support it can provide throughout the trial. This will accelerate patient recruitment and motivate more participants to remain in and complete the study—all of which will reduce clinical costs.
  • More appointable investigator sites. Sponsors with a better reputation for helping sites manage trials can convince more sites—including those with greater research experience—to participate in a trial. This can shorten the time needed to attain the number of required sites, accelerate patient recruitment, make the fees paid to trial sites more cost-effective, and improve the diversity and inclusion of patients taking part in a trial.
  • The opportunity to add innovative digital clinical trial management to the protocol. Showing empathy, meeting the needs of clinical research staff, and having a track record of running clinical trials efficiently can make it possible to add complexity to the study. Digital technology has proven to help clinical development organizations address challenges with recruitment and retention, but also requires a site to put in more time and effort to adhere to the new processes that come with such technology.

Interactions With Pharma Don’t Meet Research Staff Expectations

To gauge how well pharma provides great clinical trial experiences from the perspective of clinical research staff, we surveyed over 300 clinical trial sites using our CXQ® methodology. This methodology assumes that “customers” judge experiences based on their expectations of interactions with companies—in this case, pharma firms. Differences between expected and actual experiences lead to certain (hopefully desirable) behavior, which in a clinical trial context could be a more effective approach to recruitment or a greater willingness to collaborate with a firm on future studies. Research staff clearly expects sponsors to provide high-quality support and be flexible in setting up and running clinical trial operations and administration (see Figure 1). Other drivers that matter focus on the completeness and clarity of information the sponsor provides and how quickly it does so. Our survey of principal investigators (PIs) at clinical trial sites shows that:

  • Overall CXQ® is fair… Looking at the results of our survey of 329 PIs at participating clinical trial sites through the lens of the CXQ® methodology and CX drivers reveals an overall CXQ® score of 45 (see Figure 2). This score falls into the “fair” range; most PIs rated their experience as anything but excellent. Practically speaking, investigators want sponsors to be more supportive, more flexible, and more focused on delivering high-quality information to them and their participants.
  • … but excellent experiences boost the willingness to collaborate with a sponsor again. Clinical trial sites that give excellent CXQ® ratings to pharma sponsors say that excellent experiences make them more willing to collaborate with the sponsor and participate in research again—both key industry-wide challenges (see Figure 3). They also have a better image of the sponsor organization. Positive CX ratings are also associated with higher total time and resource allocation, greater overall effort to recruit participants, and a better perception of data quality. Clinical trial sites reporting high CXQ® scores need far less improvement in areas like digital communication channels, data flow and query handling, and integration of patient views into study design than sites that score their interactions with pharma sponsors as poor (see Figure 4).
  • Excellent CXQ® sites use and value RWD/RWE recruitment and retention tools more. Excellent trial experiences correlate with significantly higher deployment of real-world data and evidence (RWD/RWE) tools for patient retention and patient relationship management portals but lower deployment of clinical trial management and electronic data capture systems (see Figure 5). Sites are more confident using these tools when a sponsor’s support, engagement, and collaboration are all excellent. RWD/RWE tools for patient recruitment have stronger links to an overall positive experience than email, social media, and a sponsor’s own recruitment website (see Figure 6).

Figure 1: High-quality support, flexibility, and information completeness are key customer experience drivers


Figure 2: The overall CXQ® score for clinical trial site interactions is fair


Figure 3: Excellent experiences have a strong impact on willingness to collaborate with a clinical trial site again


Figure 4: Excellent experiences have a strong impact on improving study design and integrating patient views

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Figure 5: Clinical trial sites with excellent CXQ® scores value RWD/RWE digital tools and patient portals the most

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Figure 6: Clinical trial sites with excellent CXQ® scores value RWD/RWE databases for recruitment the most

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Align Clinical Op’s Digital Strategy to The Needs of Sites and Patients

The clinical trial remains one of the most sophisticated processes pharma needs to optimize today as part of its clinical development efforts. Pharma firms often consider process optimization as an internal exercise that treats the view and voice of the customer as an afterthought—or overlooks it completely. Our study shows just how much room for improvement there is, particularly if we consider a site or investigator purely as a customer. Companies like Pfizer and AstraZeneca have already recognized this and dedicated resources or a center of excellence to promoting and adopting CX capabilities in clinical development. Firms that don’t will need to launch such a transformation. They should start by appointing a regional or global role who creates a strategy and plan to not only prove the value of the program, but also coordinate the creation of specific CX practices including strategy, a design process, technology, and related operations. Practical, short-term solutions are also in play; in particular, pharma firms must:

  • Apply CX principles to clinical trial site engagement. Better CX improves not only sponsor relationships and willingness to collaborate on future studies but also clinical trial operations such as resource allocation, recruitment efforts, and data quality. To boost investigators’ experiences and ensure that the best ones collaborate with your firm again, listen to the needs of customers; design an agile clinical site CX process that you can apply to different trials and in different geographies; align the clinical ops team with CX objectives and milestones; and measure clinical trial CX regularly.
  • Support the adoption of RWD/RWE approaches for design, recruitment, and retention. Clinical trial sites that have excellent experiences with a sponsor use recruitment tools very differently; they prefer RWD/RWE over social media or their own recruitment website. Excellent CX sites also use RWD/RWE for trial execution to improve patient retention. To close the gap and get better returns on clinical trial process improvement efforts, clinical ops teams need better digital recruitment strategies supported by fit-for-purpose KPIs, including diversity and inclusion.


DT Consulting’s CXQ® Clinical Trial Site Benchmark Survey was fielded in conjunction with the DT Clinical Trial Digital Tracker Survey, Q3 2021. This was an email-initiated online survey based on the database at The survey covers 3,343 global industry-funded interventional studies that launched between April 1, 2021, and October 31, 2021, and were actively recruiting participants. We also recontacted sites included in the previous survey—2,933 global studies launched between October 1, 2020, and March 31, 2021. We received a total of 450 responses from the former group and 329 from the latter and used this data to calculate overall CXQ® scores. We received a total of 45 responses from previous respondents.

DT Consulting and Indegene contacted principal investigators via email in December 2021 and invited them to participate in the survey. Please note that respondents who use online networks, are triggered by email, and participate in online surveys have more digital experience and are more likely and confident to interact with companies digitally than those with less experience.

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Francesca Properzi crc

Francesca Properzi


Francesca has more than ten years of experience in life science and healthcare research projects, including frontline scientific research, digital transformation, and innovative technologies. In her current role as director of research, she is steering the DT thought leadership team to generate valuable insights into customer experiences, specifically in the clinical and medical affairs areas of the biopharmaceutical value chain.

Tim van Tongeren

Managing Partner

Tim has worked for more than fifteen years with commercial leaders to navigate their strategic and organizational transformations required to thrive on digital technology change. In his current role as Managing Partner, he leads DT’s Solutions and Consulting offerings to advise the world’s largest pharmaceutical firms on how to best achieve customer experience success through digital transformation.
Tim van Tongeren crc

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