Cost and ROI

How to calculate recruitment ROI for a clinical research site

By TrialNotice · Updated
Research site director in his office looking at a laptop showing a rising line chart
Short answerRecruitment ROI for a site equals the study revenue from patients a channel randomizes, minus what the channel cost, divided by that cost. To calculate it correctly, trace every randomized patient back to the source that found them and count staff time as a cost. Leads and screens do not count as return.

What is the recruitment ROI formula?

ROI = (revenue from randomized patients sourced by the channel, minus channel cost) ÷ channel cost.

Revenue is what your study budget pays for those patients' visits and procedures. Channel cost is everything you spent to find them: vendor fees, advertising, mailing, and staff time.

What does a worked example look like?

These numbers are illustrative only. Suppose a physician outreach channel costs $15,000 for the study and sources six randomized patients, and your budget pays $8,000 per completed patient. Revenue is $48,000. ROI is ($48,000 minus $15,000) ÷ $15,000, or 220%. If an ad campaign costs $9,000 and sources two randomized patients, revenue is $16,000 and ROI is about 78%, even though the ads were cheaper.

What mistakes distort recruitment ROI?

  • Counting leads instead of randomized patients. A meta analysis found online recruitment cost less per enrollee, yet 69% of studies comparing conversion found offline methods converted better (JMIR). Cheap leads that do not qualify are not cheap.
  • Leaving out staff time. In one trial across 25 practices, recruitment took 3.7 staff hours per randomized patient on average (PMC). Channels that send poorly matched patients consume that time in screening.
  • Ignoring retention. A patient who withdraws early may not generate the full budgeted revenue.

How does the sponsor see ROI?

Sponsors measure it in time. Tufts CSDD puts the direct cost of a Phase III trial at $55,716 per day (Tufts CSDD), and Phesi estimates a site that enrolls a single patient over a 30 month study costs the sponsor about $130,000 (Applied Clinical Trials). A site that adds a reliable patient source improves its own ROI and becomes a site sponsors want again.

How do you set up tracking?

  1. Record the source of every lead at first contact.
  2. Keep that source attached through screening and randomization.
  3. Log staff hours spent on each channel.
  4. Review ROI by channel monthly and shift budget toward what randomizes.

See also what it really costs to recruit one patient.

Get your study in front of the right local physicians

TrialNotice builds a physician referral pipeline around one active study. We identify relevant local physicians within driving distance of your site, send study aligned direct mail, follow up by email and LinkedIn, track engagement with recipient level QR codes, and route warm responses into your site team's workflow.

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Sources

  1. "Site specific factors associated with clinical trial recruitment efficiency in general practice settings," PMC
  2. Brøgger Mikkelsen M. et al., "Online Patient Recruitment in Clinical Trials: Systematic Review and Meta Analysis," Journal of Medical Internet Research
  3. Tufts CSDD, "Quantifying the Value of a Day of Delay in Drug Development" white paper (2024)
  4. Applied Clinical Trials, "Phesi Report: Assessing Single Patient Investigator Sites in Cancer Clinical Trials"

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