Clinical supply
Trial at home
Clinical trials have historically been done at hospitals or clinics, with subjects and researchers convening to get results. But with the rise of new technology – to say nothing of the pandemic – things are changing fast. Instead of trooping to investigation centres, subjects are increasingly undergoing trials in their own homes, using sophisticated equipment to beam data back to doctors. Naturally, this approach offers a number of ethical and practical benefi ts. Yet it’d be wrong to suggest that the direct-to-patient model is straightforward, especially when it comes to supply chains. Andrea Valentino talks to Gaurav Agrawal, life sciences partner at McKinsey, and Órlaith Burke, ‘data in health’ innovation portfolio lead at Accenture, to learn more.
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n the 1940s, the Royal Brompton Hospital was a cosy place. Photos from that time show rows of beds squeezed together with almost military discipline, their simple metal frames just a few feet apart. Nurses in plain white hats and skirts peered over their charges, and privacy is minimal. When Austin Bradford Hill came here in 1946 to conduct one of the first randomised clinical trials in history, he found himself nose to nose with his patients too. Hill wanted to test the efficacy of streptomycin on pulmonary tuberculosis, so proceeded the only way medical science knew back then: with x-rays, weight checks and sputum samples. This was science done intimately, the clinicians and their subjects spending long periods cooped up together.
Subsequent trials have been just as intimate. And how could they not be? With only rudimentary monitoring technology at their disposal, researchers have always had to get up close and personal to their patients. If nothing else, this is reflected by the statistics. As recently as 2020, work by Florence Healthcare found that nearly 80% of trial monitoring was conducted in person. Yet, if this closeness has long been central to the success of clinical trials – and shaped their supply chains along the way – there are obvious downsides too. Forcing patients to come in for tests is hardly a good way of keeping them involved and hardly immaterial when up to 40% drop out before the trial ends. As with so much else, however, the pandemic
Clinical Trials Insight /
www.worldpharmaceuticals.net
Olena Yakobchuk/
Shutterstock.com
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