When a trial goes off course, we put it back on target.
We do not replace your CRO. We diagnose why a trial or RWE study is slipping, reset the plan on real numbers, and govern it back to Right the First Time, On-Time, On-Target.
Three ways trials go off course. How each one came back.
Sponsor, study, and asset names are withheld. Each pattern is drawn from the principal's documented record, and every figure is reported as recorded, not estimated.
A division falling behind on its highest-priority trials.
Amendment after amendment.
"Very simply, [the principal] was brilliant at damage control and developing solutions that could fix the worst of projects."
Senior Clinical Project Manager who reported to the principal, top-five global CRO
"Not only did [the principal] and this model help me to recover a failing project and move the project's [risk status] away from red, but also, I applied his model to my other projects and those projects have stayed green for over 16 months!!"
Senior Clinical Project Manager who reported to the principal, top-five global CRO
If one of these patterns looks like your program, that is the first ten minutes of a rescue assessment.
The data partner brings the asset. Clinical TrialRx makes sure the study delivers.
Delays show up in real-world data long before they show up on a timeline. Clinical TrialRx tests the protocol, the sites, and the enrollment plan against real patients first.
- Originated point-of-care data partners
- Data infrastructure and tokenization partners
- RWE analytics partners
- Protocol stress-testing and feasibility
- Site selection on real patient counts
- Governance of monitoring and data lock
- One accountable plan
- One bid, one delivery team
- Evidence built for the use it must survive
The enrollment play, every phase: start where the patients already are.
Real-world data shows where eligible patients are before a single site is chosen. Sites are selected on verified patient counts, not phantom feasibility numbers, so studies are positioned to start and finish on schedule.
Where trials lose time, and what Clinical TrialRx does at each point.
Feasibility and protocol design
Where it breaksEligibility criteria are written for patients who are rare in practice.
What we doTest eligibility, visit burden, and endpoints against real patients before first patient in.
Site selection
Where it breaksSites are chosen from surveys that overstate available patients.
What we doRank sites by real patient counts and past enrollment, not survey answers.
Enrollment
Where it breaksShortfalls are found after the enrollment window is already lost.
What we doForecast site-level enrollment from real-world data and flag shortfalls early. Work with partners to identify likely eligible populations near active sites, using de-identified, tokenized data under each partner's privacy, consent, and IRB-approved recruitment framework.
Amendments
Where it breaksEach amendment cycle runs 260 days, and one Phase III amendment carries a $535K median direct cost (benchmarks above).
What we doEvery amendment avoided at design removes a cycle from the timeline. Tufts CSDD estimates a day of delay costs about $40,000 in direct Phase II and III trial cost and about $800,000 in lost prescription sales (2024).
Rescue
Where it breaksA late trial has no evidence of why it is late.
What we doRun the existing rescue method (VOC and Seven Pains audit, Stage-Gate governance, FSP oversight) with the data partner layer alongside it, to re-forecast enrollment, re-target sites, and reset the plan on real numbers.
RWE is not a phase
Where it breaksReal-world evidence is treated as a post-market afterthought.
What we doCarry the same real-world data from feasibility through Phases I to IV and post-market, so external controls, label expansion, safety surveillance, and payer evidence draw on one consistent evidence base. See the RWE Doctrine.
The translator between the platform and the science.
Data platforms are bought for what they promise; studies are judged by what they deliver. In prior roles, the principal has taken CTMS, EDC, monitoring software, and AI/ML from purchase into live operation, including a global CTMS implementation across 21 international affiliates. In RWE leadership roles, that work extended to direct review of the underlying program data: living reviews of global registries and claims databases, and orphan-disease burden estimates built for regulatory-grade submissions.
How the partnership runs: VOC and Seven Pains, Business Acquisition Process (BAP), and Business Execution Process (BEP).
Before the offer reaches a sponsor, diagnose which of the seven reasons sponsors say NO is already in play, so the proposal answers the objection.
Joint pursuit from Interest through Win, with the data asset and the execution plan in one bid, so the sponsor buys one accountable answer.
Define through Close, with every data commitment made in the bid carried into delivery without translation loss.
Your trial is late, or about to be.
Start with a delay rescue assessment: where the timeline is slipping, what the data shows, and the governed path back.
Schedule a Delay Rescue AssessmentYou have the data. Your sponsors need the study delivered.
Bring Clinical TrialRx in as the study oversight layer for your sponsor engagements.
Partner With UsWhy about 80% of clinical trials miss their enrollment timelines, and what it costs sponsors.
Trial delays do not come from one failure. They compound across start-up, site activation, recruitment, and contracting, each adding months, amendment cycles, and burn. The data below maps where pharma, biotech, and device programs are losing the race.
If your trial shows two or more of these signals, it is time for an independent assessment, before drift turns into an amendment.
Miss initial enrollment targets
About 80% of clinical trials fail to meet their initial enrollment target and timeline, a benchmark repeated across the recruitment literature for a decade.
Contracts and budgets named the top fix
of about 100 site professionals surveyed named contract and budget support as the top area where sponsors and CROs can improve.
Contract and budget delays "frequently"
of site respondents report experiencing contract and budget delays frequently, a recurring start-up constraint rather than a one-off negotiation issue.
Participants who stop early
In a 2025 survey of 4,415 past participants, 11% stopped before their last scheduled visit.
Spent between trials
IQVIA reports that inter-trial intervals account for about 17 months of total development time across an R&D program (2025).
Labs still digitally siloed
of 104 biopharma R&D executives surveyed report that their R&D labs remain digitally siloed.
Each month a drug reaches market late costs about $24M in lost sales. Estimate based on Tufts CSDD: about $800,000 per day in lost prescription drug and biologic sales (Smith, DiMasi, and Getz, 2024).
The two most expensive words in clinical development: protocol amendment and enrollment extension.
Amendments are one of the most common and costly sources of unplanned delay and unbudgeted expense in clinical trials, and the industry benchmark is moving in the wrong direction. The data below is why every Clinical TrialRx engagement is architected to prevent the amendment, not merely process it.
Protocols now amended
of Phase I-IV protocols carry at least one substantial amendment, up from 57 percent in 2015. The mean number of amendments per protocol has climbed 60 percent to 3.3.
Need-to-amend to final approval
Average time from identifying the need to amend through the last oversight approval. Sites operate on divergent protocol versions for a mean of 215 days across that window.
Median cost per Phase III amendment
Median direct implementation cost of one substantial Phase III amendment ($141K at Phase II), as reported in 2016. No newer published median cost benchmark was found, and rising protocol complexity suggests the true figure is higher still.
In the principal's rescue engagements, in Phase I to IV clinical trials and RWE/RWD studies across therapeutic areas, Stage-Gate protocol governance and submissible evidence packs cut amendment cycles 45 percent, because the cheapest amendment is the one the design never needed.
The first 90 days. Diagnose, stabilize, deliver.
Diagnose
Study health check; risks ranked against the seven reasons sponsors say no
Stabilize
Stage-Gate cadence, governance, and delivery metrics live
Deliver
Results on the scoreboard; the recovery locked in, or a clean handoff to your team
"[The principal] made an immediate impact on the business and was able to quickly understand the complexities of our organization, mobilize the team, and deliver results."
Project Management Supervisor who reported to the principal, leading global central lab
One path from SOW to data lock. Every study, every month.
Protocol and SOW reviewed before the price is set
Team, scope, and schedule baselined
Sites, training, and risk log ready
Reviews at every enrollment milestone
Data cleaned and queries closed early
Audit-ready file and lessons learned
Straight answers, before the first call.
When should a sponsor bring in a rescue partner instead of switching CROs?
When enrollment is behind plan, change orders are climbing, or the CRO team keeps turning over. A CRO transition restarts start-up work while the study is already late. Clinical TrialRx does not replace your CRO: it diagnoses why the study is slipping, resets the plan on real numbers, and governs every party back to Right the First Time, On-Time, On-Target.
What happens in a rescue assessment?
A 30-minute call that shows where the program has drifted, which of the Seven Pains are dragging it, and a governed path to recovery. For emerging biotech leaders, the fixed-scope 30-day Biotech Rescue delivers a recovery plan with named owners that your board and your CRO can both run.
What kinds of studies does Clinical TrialRx rescue?
Phase I to IV clinical trials and RWE studies across therapeutic areas. The principal's documented record includes 30+ rescues across 22+ therapeutic areas, with programs covering 24,623+ patients and 1,092+ sites.
How is rescue progress measured?
Through Stage-Gate governance and rescue performance metrics: SOW adherence, site activation, data delivery, budget compliance, and Voice of the Client. Leadership sees them at a weekly client meeting and a monthly leadership review. In prior roles, this method cut rescue-trial amendment cycles by 45% and landed data locks an average of 38 days ahead of schedule.
How can I tell if my trial is off track before the timeline shows it?
Six signals usually appear first: eligibility that does not match real patients, sites that never activate, enrollment shortfalls found late, repeat amendments, change orders traced to scoping, and data lock slipping. The guide Six Warning Signs a Clinical Trial Is Off Track walks through each one and the first move to make.
Your trial is off-course.
We put it back on target.
Start with a no-obligation rescue assessment. We will diagnose where your program has drifted, map the VOC and Seven Pains failure points actively dragging it, and show you a governed path to recovery in 30 minutes.
Pittsboro, IN 46167