Diversify the Clinical Trial Workforce to Drive Patient Population Diversity

Nadege T. Gunn

Nadege T. Gunn, MD, CPI, Medical Director, Impact Research Institute

“I’ve heard too much talk and not seen enough action” when it comes to improving diversity both in the patient population and clinical trial workforce, says Nadege T. Gunn, MD, CPI, medical director for Impact Research Institute in Waco, Texas.

Acknowledging that the drug and medical device research and development enterprise faces a thorny combination of “pitfalls and challenges” in both instances, Gunn nonetheless maintains it is long overdue when it comes to putting genuine muscle behind its well-intentioned words. She calls on the clinical trial industry to expand opportunities for minorities in the profession. Doing so will strengthen the profession even as it attracts more minorities to consider participating in trials, she notes.

An effective clinical trial recruitment team needs to have members who look like the patient population they are trying to reach, Gunn adds. “It adds to a sense of trust” among other positive elements, she says.

It also adds to a sense of reality, Gunn explains. She notes a study she was working on in which the drug under consideration had a price tag of around $500 per month. “The sponsor was glad to reimburse, but didn’t seem to understand that a lot of the potential patients were low-income” and couldn’t afford to shell out the $500 up front and wait to get it back later.

The ignorance isn’t limited to sponsors, of course. Separately, a Wharton School of Business professor recently made headlines by demonstrating how relatively out of touch some Americans are about the financial condition of their fellow citizens. Nina Strohminger, a legal studies and business law professor at Wharton, wrote on Twitter that one-quarter of her students thought the average American’s salary was at least six figures, and one even thought it was $800,000 a year.

Gunn believes it is vital to have minorities at the “table where the decisions are being made and the trials designed” to infuse a sense of reality into the planning. Patient advocates and people of color should be involved in the conversation and trial design from the very beginning—to anticipate issues like the $500 drug, or how other factors like lack of mobility or insurance could preclude high levels of participation in some patient populations.

“We need the right people” in the room at the very outset, Gunn says.

Author: Michael Causey