Clinical Trials: Patients Want In, But Hurdles Remain

Clinical trials are crucial for advancing medical treatments, but patient participation faces significant hurdles. A vast majority of individuals with chronic illnesses are willing to join trials, yet two-thirds report that their healthcare providers have never discussed these options. Furthermore, only a small percentage of adults have ever been invited to participate.

Recruitment challenges are substantial, with up to 86% of trials failing to meet their enrollment targets. Beyond recruitment, patient retention is also difficult, as access and affordability often become issues at every interaction point.

Efforts are underway to improve this landscape. In June 2026, the Department of Health and Human Services announced initiatives to streamline clinical research, including exploring rule changes for compensating participants for expenses like travel and lodging. Additionally, a proposed bill, the Clinical Trial Modernization Act, aims to allow sponsors to cover medical and non-medical costs for participants.

Patients may join trials for various reasons, including seeking life-extending treatments for serious illnesses or contributing to scientific advancement. Even if not receiving the experimental therapy, participants often receive close monitoring and high-quality care. However, finding trials can be difficult, as doctors may not always refer patients, and online searches can be complex.

Geographic and financial barriers remain primary obstacles. Many trials are concentrated at urban academic centers, making them inaccessible for those living far away. Even when trials are available and patients meet eligibility criteria, costs associated with travel, lodging, childcare, and time off work can be prohibitive, despite some coverage mandates under the Affordable Care Act and other programs.

Decentralized clinical trials, allowing some tasks to be done remotely, are emerging as a potential solution to increase access and diversity in participation, though this model is not yet common. Patients are encouraged to inquire directly about potential financial assistance for incidental trial-related expenses.