As mentioned in Part 1 of this blog series, 78% of respondents in the CenterWatch Monthly survey rated the overall usefulness of investigator meetings as “Good” or “Excellent.” But how does one define usefulness? To whom is the meeting useful and for what reason? According to one of the respondents, “The networking is, frankly, the only reason I’m there.” He was referring to his ability to directly ask sponsor representatives for additional studies.
There may be some benefit to the sponsor being aware that a particular doctor is interested in handling more studies. However, this is clearly not the intent of the investigator meeting. It is hard to see how this type of use of an investigator meeting is of much value to the sponsor. In other words, if many of those respondents who gave good marks to these meetings were doing so based on their ability to do personal business, one wonders how seriously to take the survey results.
Investigators find meetings overstuffed with unnecessary or redundant information to be a waste of time. This is the case because they often fragment attendees. This is done in terms of job roles (principal investigator, study coordinator, sub-investigator, monitor, etc.) and level of knowledge or experience regarding the study drug or clinical trials in general. As a result, each presentation will be of interest to some while completely boring to others.
Typically, organizers gear meeting materials toward the rookies. This tends to annoy the more experienced investigators. These are the very ones that the sponsors should be trying hardest to retain. The thought of having to go through hours and hours of GCP training for the 29th time can make a veteran investigator think twice before agreeing to attend the meeting. This leads to generally poor principal investigator attendance rates. Figures vary from sponsor to sponsor, but many in the industry place that number in the 40% to 60% range.
These days, more and more sponsor companies are keeping a close eye on costs, and these meetings can be a big financial sinkhole. Figures vary by sponsor, but most companies peg that number at around $2,000+ per attendee.
. . .consider a typical Phase III investigator meeting . . . this type of meeting a sponsor can expect to pay approximately $240,000. Larger studies can approach the $1 million dollar mark.
For instance, consider a typical Phase III investigator meeting for a study with 50 sites and 2 attendees per site (adding in another 20 attendees from the sponsor and its vendors). For this type of meeting a sponsor can expect to pay approximately $240,000. Larger studies can approach the $1 million dollar mark. Given that large pharma companies can have 100 or more studies per year, there is can cause alarm in the accounting department.
The figures given in the preceding paragraphs don’t things like lost productivity. Sponsor personnel are tied up for several days while attending the meeting (potentially four or five, including travel time). The impact can be significant from a financial aspect, not to mention the potential for disruption of study timelines. From the site perspective, there is a similar productivity issue. A doctor’s practice will also lose revenue for those days spent attending the meeting. Time spent away from family and friends can be distracting at the least and cause resentment in the extreme.
Finally, do attendees leave the meeting knowing more than they did at the outset? Was the cost of the meeting justified by the increase in knowledge? The effectiveness of the presentation marathon approach (known in some circles as “Death by PowerPoint”) used at most investigator meetings is questionable at best. While the sponsor retains records that people showed up at the meeting, they have no way of knowing if anyone actually learned anything.
Other factors, such as timing and turnover, can also have an impact on the long-term effectiveness of training. The timing of the meeting relative to first patient screened, for example, can mitigate many benefits gleaned. A site may not see its first patient for three to six months (or longer) after the meeting. At that point, here is a good chance they will have forgotten much of their training. Turnover is another issue. If a study coordinator leaves a site for a new job one year into a three-year study, chances are that his or her replacement will not receive the same training that their predecessor did.