Patient Recruitment and Retention Key to Clinical Trial Derisking as Market Grows
Phase III trial dropout rates have doubled and protocol deviations rose 184%, underscoring patient recruitment and retention as key derisking levers. The recruitment services market is projected to reach $5.69 billion by 2030.
Patient recruitment and retention have emerged as central challenges in clinical trial execution, with dropout rates doubling and protocol deviations rising sharply, while the market for recruitment and retention services is projected to reach $5.69 billion by 2030. New data and industry strategies presented at the Outsourcing in Clinical Trials Europe 2026 Conference in Barcelona, Spain, from 6–7 May highlight patient-centric design, site collaboration, and technology as key derisking levers.
Based on a Tufts Center for the Study of Drug Development analysis of 10-year data for Phase III pivotal trials, trial dropout rates have doubled. The total number of protocol deviations was up 184% between 2013–2015 and 2023–2025, which manifests as increased burden at the sites.
The completion of questionnaires and diaries is the fastest growing area of procedural burden in protocols. According to a Center for Information and Study on Clinical Research Participation survey, 32% (n=5,505) of respondents said the completion of diaries and questionnaires was “somewhat” or “very burdensome” in 2025, rising from 18% (n=3654) in 2021.
In a survey conducted by GlobalData, the top strategy to improve patient recruitment identified by industry professionals was designing trials with a patient-centric approach. Furthermore, 79% of 120 respondents said that patient advocates had a “somewhat” or “substantial” impact on recruitment. Dermatology-focused pharma company Almirall has recently incorporated patient advisory boards earlier in the trial design process to ensure the protocols reflect patient needs.
At the SCOPE Summit 2026, the founder and CEO of mdgroup discussed how treating patient experience as a strategic investment—rather than a supporting activity—fundamentally reshapes clinical operations. She cited the example of a patient with a rare disease who dropped out of a study because, as a single mother working nine to five, she could not attend a clinic visit on a Wednesday at noon. That patient later founded the Serenely Guided Foundation, which provides materials to sites to inform patients about available support services that can help them enroll and stay in studies.
Novel technologies are also being applied to reduce site and patient burden. The CEO of Replior, a software company specialising in data collection for clinical trials, highlighted gamification of participation, such as incorporating rewards or points, as a tool to enhance patient experience. Remote monitoring tools, including a ring-based wearable sensor used to track scratching and sleep in itch trials, were also noted for their potential to reduce patient burden and the need for face-to-face interaction.
The patient recruitment and retention services market is projected to reach a valuation of $5.69 billion by 2030, corresponding to a compound annual growth rate (CAGR) of 6.1%. Key factors propelling this rise include the increasing deployment of artificial intelligence and digital recruitment platforms, heightened emphasis on patient retention strategies, expanded use of remote and decentralized clinical trials, incorporation of real-time monitoring and analytics, and the broadening of global patient recruitment networks. In January 2024, U.S.-based telehealth and diagnostics provider eMed acquired Science37 Holdings for an undisclosed sum, aiming to extend eMed's footprint into decentralized clinical trials by integrating Science37's patient-centric recruitment platform, which accelerates enrollment and broadens trial access.