Financial Incentives for Research Participation: Empirical Questions, Available Answers and the Burden of Further Proof

Abstract

The growing gap between the supply of and demand for clinical research participants has motivated efforts to better understand how people make decisions to participate in research and specifically what investigators ethically can do to improve study enrollment. Among the several reasons why potential research subjects would or would not participate in studies, the opportunity for financial compensation or benefit often figures prominently among both patients 1. Halpern S.D. Prospective preference assessment: a method to enhance the ethics and efficiency of randomized controlled trials. Control Clin Trials. 2002; 23: 274-288 Abstract Full Text Full Text PDF PubMed Scopus (52) Google Scholar and healthy volunteers (Stunkel and Grady, “More than the money: a review of the literature examining healthy volunteer motivations,” unpublished). Common sense, anecdotal experiences and the few empirical analyses conducted to date all suggest that financial incentives are effective ways to increase study enrollment and that larger incentives are more effective than are smaller ones. 2. Bentley J.P. Thacker P.G. The influence of risk and monetary payment on the research participation decision making process. J Med Ethics. 2004; 30: 293-298 Crossref PubMed Scopus (213) Google Scholar , 3. Halpern S.D. Karlawish J.H.T. Casarett D. et al. Empirical assessment of whether moderate payments are undue or unjust inducements for participation in clinical trials. Arch Intern Med. 2004; 164: 801-803 Crossref PubMed Scopus (130) Google Scholar Although financial incentives for research participation are common, 4. Grady C. Dickert N. Jawetz T. et al. An analysis of US practices of paying research participants. Contemp Clin Trials. 2005; 26: 365-375 Abstract Full Text Full Text PDF PubMed Scopus (82) Google Scholar the practice remains controversial. Unfortunately, commentators on the ethics of incentives for research have been united far more by the fervor of their arguments than by the underlying concepts on which the arguments are based.