A cross-sectional survey on patient perception of subject payment for research

Abstract

Background: Research subjects may receive payment for their participation. Multiple models for payment have been proposed, however, the most ethical model is not completely clear. Objective: The purpose of the present study is to evaluate and quantify the public’s perception and to identify demographic determinants influencing said perceptions. Methods: Patients from a New York City medical clinic were queried using an adapted survey on medical research compensation consisting of 6 opinion-style questions pertaining to the payment of subjects enrolling in clinical trials and 9 demographic questions. Pearson’s chi-squared tests of independence with two-tailed alpha of 0.05 and correction for multiple testing were performed to determine statistical significance. Results: 440 respondents were recruited for participation, with broad distribution across age, race, and socioeconomic levels. For research payment, surveyed respondents preferred the market model (n = 265, 62%) compared to the reimbursement model (n = 72, 16.8%) or wage payment model (n = 64, 15%) and no payment (n = 27, 6.3%). Patients under the age of 60 were more likely to choose the market model ( p = .01) compared to those over 60 selecting the reimbursement model ( p = .001). 88.7% (n = 377) of respondents indicated they did not perceive clinical trial payment to be a bribe, with non-white patients being more likely to identify payment as a bribe ( p = .025). 73.2% of respondents (n = 344) believed that poorer individuals were more likely to enroll. Patients without high school education and patients 60 years of age or older were more likely to believe that payment ( p = .006 and p < .001, respectively) would have no influence on enrollment than those with high school education. Conclusions: Differences in mind-set towards clinical trials demonstrate older patients and individuals without a high school education may have differing opinions with regards to financial incentives in clinical trials. Sensitivity towards these attitudes may require alternative models of payment for future clinical trials.