# How clinical trial recruitment cost is modeled

Canonical page: <https://dyno.clinicaltrialscan.ai/>

This page explains the structure of a clinical trial patient recruitment budget
and how Clinical Trial Scan's DYNO Ai 2.0™ platform derives one from a protocol.
It does not publish cost benchmarks; those are produced per protocol and
geography inside the platform.

## The three cost components

1. **Advertising budget (media).** What it costs to generate patient interest in
   a defined geography. Expressed as cost per lead and, after applying funnel
   probabilities, cost per randomized enrollment.
2. **Site activation.** A fixed per-site fee covering onboarding, training, and
   integration into the recruitment workflow.
3. **Per-enrollment performance fee.** A fixed fee paid on a randomized patient,
   independent of media performance.

Cost per enrollment is treated strictly as an advertising performance metric. It
does not absorb site activation or performance fees, because mixing fixed fees
into a media efficiency number makes it impossible to tell whether advertising
or protocol design caused an overspend.

## From cost per lead to cost per enrollment

Cost per enrollment equals cost per lead divided by the product of the funnel
stage probabilities (P2 through P7). A study with a 60% phone-screen pass rate,
a 64% show rate, and a 40% screen pass rate converts leads to enrollments at
roughly 15% before the remaining stages are applied — so the cost per enrolled
patient is many times the cost per lead. Underestimating any single stage
compounds through every stage below it.

## What drives the number up

- **Rare or narrowly defined indications.** Fewer eligible patients per
  thousand people reached.
- **Record-verifiable exclusions.** Criteria that only medical records, labs, or
  imaging can confirm push failures late in the funnel, after money has been
  spent on booking and site visits.
- **Narrow eligible age ranges.** The age mix of the local population, not its
  total size, determines reachable volume.
- **Geographic media cost.** The same indication costs materially different
  amounts per lead across metro areas.
- **Show rate depression.** Indication burden, travel distance, and lack of
  caregiver support reduce attendance on already-paid-for bookings.

## Why averages mislead

Industry per-patient recruitment averages blend protocols with very different
eligibility structures. Two studies in the same indication and phase can differ
several-fold in true cost per enrollment purely because one adds a handful of
record-verifiable exclusion criteria. A staged model exposes that difference
before the budget is committed; an average cannot.

## Getting a protocol-specific model

Clinical Trial Scan produces a full forecast — funnel probabilities, addressable
population, advertising budget scenarios, and total contract value — from an
uploaded protocol or an NCT identifier.
Start at <https://dyno.clinicaltrialscan.ai/>.