I recently wrote a LinkedIn post titled ‘The Sponsor Perspective Problem.’
Sponsors fund clinical trials. They take on risk. They want results. That makes sense. But here’s the issue—many sponsors believe that because they carry the cost, they understand the needs of every other stakeholder. That’s where the disconnect starts.
– If you’ve never sat with a patient walking through their fourth informed consent form…
– If you’ve never tried to explain a placebo to someone with late-stage illness…
– If you’ve never asked a parent to take two weeks off work for an underpaid study visit…
Then you’re not seeing the whole picture. The sponsor perspective is necessary—but it’s not complete. Building better trials means making room for the perspectives that don’t sit in the budget spreadsheet.
It’s easy to assume that the one footing the bill understands the full picture. In clinical research, that assumption often goes unchecked. Sponsors—whether pharmaceutical companies, biotech firms, or contract research organisations—hold enormous influence. But power does not guarantee perspective.
Just because you’re paying for a study doesn’t mean you understand what matters most to every person involved. Especially patients. And when we ignore this, trials don’t just become inefficient—they become misaligned with their purpose.
When we talk about who a trial is serving, we often default to scientific outcomes, business strategy, and regulatory approval. But trials should also be a service to patients, communities, and public health. If sponsors overlook these goals, they risk delivering something technically valid but practically irrelevant.
The sponsor’s view is often defined by deliverables: endpoints, timelines, and budgets. These are critical. But they’re not the whole story. A trial can hit every milestone on paper and still fail the people it’s meant to help.
When trials are designed primarily from a sponsor perspective, patient needs get filtered through the lens of convenience and cost. What’s logistically possible? What can we get approved quickly? What’s easiest to track? These are valid questions—but they’re not the only ones we should be asking.
There’s often an overconfidence in systems built around efficiency, even when they’re failing to connect with patients. For example, a trial might technically meet recruitment numbers but take twice as long as projected due to avoidable dropouts. What’s the cost of that lost time?
Sponsors need to look beyond the spreadsheet. What are the emotional costs to patients? What barriers are built into the system that don’t show up in line items? What assumptions are being made about what patients can and will do?
If we want to fix what’s broken, we have to be willing to see what’s missing. And what’s often missing is the lived reality of patients and frontline clinical teams.
There’s an unspoken dynamic in clinical research that needs addressing: the belief that funding equals authority. That whoever writes the cheques gets to decide what matters. But having money doesn’t mean having insight.
This mindset has real consequences. It shapes how protocols are written, how sites are chosen, how materials are developed, and how success is measured. Too often, decisions are made in boardrooms far removed from the realities of patients’ daily lives.
Sponsors may not see the full picture of what it’s like to join a trial, travel regularly to a site, manage side effects with little support, or feel like a number on a spreadsheet. And that disconnect creates friction—not just for patients, but for sites and researchers too.
Dropout rates rise. Patient trust erodes. Staff burn out. These are symptoms of a system that assumes it knows best without asking.
It’s time we acknowledged the limits of a sponsor-led model. If you want a trial to serve patients, their voices need to shape it—not just respond to it. That shift requires a change in culture, not just policy. And it starts by recognising that data doesn’t tell the whole story—people do.
Patient engagement has become a buzzword. But too often, it’s shallow. A focus group here, a survey there. Maybe an advisory board that gets brought in late with little power to shape anything meaningful.
That’s not engagement. That’s observation.
True patient engagement means involving patients early and consistently, all the way to the finish line. It means letting them co-design materials, review protocols, and flag barriers before they become problems. It means building flexibility into trials based on patient realities, not sponsor convenience.
Engagement also involves listening between the lines. What patients don’t say directly is often just as important. Fear, hesitation, or silence may point to issues with accessibility, understanding, or prior negative experiences. Sponsors must be helped to hear these signals and respond with more than standard responses.
One of the clearest signs of genuine engagement is adaptation. If you ask patients what they need, and your study doesn’t change at all, what was the point? Listening without change is performance, not partnership.
Engagement must also reflect diversity—not only in race, gender, and age, but in geography, health literacy, and lived experience. If we only engage patients who are easiest to reach, we’re building a trial that excludes by design.
When engagement is real, patients become more than participants. They become contributors. They invest in the success of the trial because they see their input valued and reflected in the outcome.
If we say trials are for patients, but design them to serve the sponsor’s workflow, we’re not being honest. And if we’re not honest about that, we can’t fix it.
It’s time for sponsors to step back and ask: Who are we really serving? Are we designing trials that serve business objectives, or patient needs? Can it be both? Yes—but only if patients are part of the process from day one.
The best clinical science often comes from unexpected questions. Patients ask things researchers don’t. They live in a space between theory and reality, and that’s where many trials struggle most. When we design with them, we build studies that not only work on paper but also in real life.
And when sponsors show they’re willing to listen, trust grows. That trust can’t be bought with brochures or branding. It has to be earned with action, consistency, and respect.
Let’s also remember that sites and clinicians are stakeholders too. They need tools, training, and time to support patient-centred approaches. If sponsor goals ignore site burdens, everyone loses.
Transparency helps here. Be open about why decisions are made. Share challenges. Ask for help solving them. When patients and providers are treated as collaborators, not contractors, the trial ecosystem becomes stronger for everyone involved—at every level.
Keith Berelowitz is the Founder of trialport, a company redefining patient engagement and retention in clinical trials using living experience, proven methods, and AI.