Clinical Trials Face Significant Recruitment and Retention Challenges in the U.S.
Clinical trials in the United States are encountering substantial hurdles in recruiting and retaining participants, with an estimated 86% of trials failing to meet their recruitment targets. A recent online survey revealed that 71% of chronic condition patients would likely participate in a clinical trial, yet two-thirds reported their healthcare providers had never discussed trials with them. Furthermore, a 2020 study indicated that only 9% of adults had ever been invited to participate. Key challenges include the difficulty for patients to find appropriate trials, the geographic concentration of research at large urban academic medical centers, and financial barriers such as travel, lodging, and childcare costs. Even when trials are identified, patients often face issues with eligibility criteria and the financial implications of participation, despite some costs being covered by trial sponsors and, for routine care, by insurance under the Affordable Care Act, Medicare, and Medicaid. 
