Clinical trial coordinators juggle countless responsibilities, from managing trial logistics, to recruiting, to clinical card systems and to ensuring protocol compliance. Participant compensation and payment is one often-overlooked task that can damage even the most well-run study.
Clinical coordinators have enough on their plates. Managing clinical card payments shouldn’t be another headache. Yet, outdated or rigid participant reimbursement systems are creating confusion, frustration, and extra work. When payments fail, trust breaks down. Let’s look at why compensation systems are struggling and how smarter solutions can improve the entire trial experience.
Digital payment platforms and prepaid clinical trial card systems were introduced to simplify reimbursements and reduce administrative burdens. But these tools are creating just as many problems as they solve. Participants report payment delays, declined cards, poor support, declining value and unclear instructions. These payment issues negatively affect the study participant experience, and they affect recruitment, retention, and overall trial success.
Unreliable and inconsistent participant payment systems can seriously damage a study’s reputation. Declined cards, confused participants, and hours lost on support calls are just some of the most frequently reported issues with clinical trial card payments.
Clinical trial success relies on trust and follow-through. Inconsistent compensation processes reflect poorly on the research study and deter participants from future participation. Frustrated participants may drop out or turn their frustration towards clinical trial coordinators.
When compensation fails, so does confidence in the study. Coordinators must ensure compensation payment is smooth, timely, and reliable to protect credibility and participant relationships.
Trial coordinators and administrators need a voice in deciding the best payment and reimbursement methods. It is important for everyone in a trial to understand how the issues related to payments affect participants’ experiences and ultimately the success and reputation of the trial.
Document any issues that are occurring with clinical payment cards and share them with the study sponsor, Principal Investigator and management teams
Here are the top issues with current clinical card payment platforms and how to fix them.
Participants expect fast, reliable payments—but many trial participants report that their cards are declined, don’t activate properly, or suddenly stop working. Social media is rife with complaints about issues that cover a multitude of issues.
For trial subjects, this can be more than an inconvenience. If participants rely on that payment to cover gas, groceries, or bills, a delay or failed transaction can feel frustrating and cause untold inconvenience. Trial coordinators are usually the first person that participants call to rectify problems.
Offering multiple payment choices allows participants to choose a compensation method that is most comfortable and familiar to them, rather than forcing a choice that won’t work for them.
While prepaid clinical card systems seem convenient, they don’t always work well for the unbanked or for participants with limited access to technology, or unfamiliarity with digital finance. Some clinical systems don’t support the availability of ATM withdrawals, which may make funds inaccessible for participants.
This creates an equity issue. Participants from underserved communities are often the hardest to recruit. Lack of payment flexibility will disproportionately affect folks with marginal access. Ensure that payment modes offer all participants the flexibility they require.
Many clinical card payment instruments like prepaid debit cards and stored value cards will lose value over time due to the built-in monthly maintenance and inactivity fees. Here are a few common examples that become red flags to participants and needlessly destroy goodwill.
All available payment options should be clearly displayed, along with any associated merchant or transaction fees, so that recipients can make informed choices. Prepaid debit cards should be free of activation or ATM withdrawal fees, and digital payment methods should clearly display their transfer fee. Full transparency about potential fees ensures participants can select the option that best suits their needs without unexpected deductions.
Inactivity Fees
When a participant doesn’t use the card for a certain period, inactivity fees may be deducted monthly. This charge can vary and be $2.95 or more per month. A $50 card with no activity for six months could be stripped of value and reduced to $32.30 after charging monthly fees.
Maintenance Fees
Some clinical cards charge monthly service fees even if the card is used. These charges are more common after an initial “grace period.” For example, a card will charge a $3 monthly fee, after six months, which will also drain the value.
Expiration Dates
While funds may still legally remain valid, physical cards can “expire.” If the participant doesn’t request a new one card, which often costs extra, the remaining balance becomes inaccessible.
Hidden Fees
Some clinical cards may levy transaction fees for certain purchases (e.g., online payments or international use) that also reduce the card balance. These are often done without clear warnings.
Whenever possible, offer multiple payment options: prepaid card, direct deposit, mobile wallet, or even traditional checks. Flexibility is one of the most participant-friendly features you can offer.
It’s important to offer a mix of payment options so participants can choose what works best for them. This could include things like gift cards, direct bank deposits, prepaid debit cards, PayPal, or Venmo. A little variety goes a long way to ensure that the preferred choice is available to all participants. Adding in a few fun, branded items like study swag or logo gear may also be a great way to say thanks and help participants feel more connected to the research.
Payment systems and clinical cards were supposed to make the job of administering trial compensation easier. Trial coordinators often spend hours troubleshooting card problems, contacting vendors, and explaining fee structures to confused participants.
That time adds up and reduces the time available for higher-value tasks like patient care, protocol compliance, and data integrity.
A good payment system – Incentive Automation – should take the hassle out of the process. By automating things like sending payments, tracking balances, and keeping records, research teams can save time, avoid mistakes, and stay focused on what really matters: running the study and supporting participants.
Payment transparency is critical, but many participants report being unsure of when they’ll be paid, how much they’re owed, or how to use their compensation. Some payment systems include expiration dates, inactivity fees, as well as limited merchant compatibility. All of this leads to participant confusion. Study coordinators often find themselves fielding basic financial questions that are time consuming to investigate.
A simple tactic to make the process easier is to curate a small selection of reimbursement choices and then publish a simple guide explaining the rules around each one. Do not leave communicating the parameters of reimbursement choice up to outside vendors. Make sure participants can easily see all their payment options and understand any fees involved, so they know exactly what to expect.
Trust is the foundation of any successful clinical trial. When payment issues occur participants may feel unappreciated or misused. This can lead to dropouts, no-shows, as well as negative online reviews that hurt reputation and hinder recruitment efforts.
Don’t let poor payment experiences undo trust.
Always follow up with participants after the first payment to ensure that everything is satisfactory. A quick check-in with participants helps you catch issues early and shows that you care.
Here’s a quick recap of ways the participant’s payment experience could be improved by research organizations rethinking their approach to compensation:
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