OnCo
ideasIdea

Pay investigators for finishing and publishing trials, not for enrolling patients

Trial sites are paid per patient recruited, so nobody is paid to finish the study or report the answer. Shift part of the payment to completion and publication within a year.

Sponsors and public funders restructure site and investigator payments so that a meaningful share (for example 25%) is held back and paid on completion of follow-up, database lock and public results posting within twelve months of the primary completion date, with a further bonus for peer-reviewed publication of negative results. Academic centres pass this through to investigator research accounts. Trial non-reporting remains common years after completion, and academic trials in particular stall in analysis and writing because the incentive ends with the last patient.

Hypothesis
Completion- and reporting-linked payments raise the share of trials with results posted within twelve months of primary completion from the current minority to above 80% at participating sites, and reduce the analysis-to-publication interval by at least six months.
Rationale
Results reporting rose sharply where enforcement existed (the FDA Amendments Act compliance improved once penalties were publicised; the EU trials tracker shamed institutions into action). Money attached to the milestone is a stronger and cheaper lever than penalties.
What would test it
A public funder applies the payment structure to all trials in one funding round and compares reporting timeliness with the previous round.
Maturity
speculative
Who has to act
clinic
Cost to try
Small (under $1M)
Years to first evidence
2
Bottlenecks it attacks

Connected

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