What if every patient stayed in the study?

Not because of an app.

Or a portal.

Or a login.

Or a password.

Only because they picked up the phone, and somebody answered.

Somebody who knows the study by heart, and has all the time in the world.

Because the people who leave take the answer with them.

And somebody out there is still waiting for that answer.

For the people who volunteered

The number your patients call when your site is closed.

Trialpal is one phone number you give every patient in your study. It answers their questions about the study in seconds, in their language, using only words your IRB approved. When they need a person, it calls your site, sits on hold for them, and brings them onto the call. Every conversation is on the record, and nobody is ever left holding a question alone.

Call the demo line → See how it works

Answers in about a second, in twelve languages, on any phone she already owns.

Dosing and timing Visit dates Fasting rules Symptoms to report Travel and parking Reminder calls

Why patients quit

Patients are told to call the site with questions. Most of the time, that call goes nowhere.

She volunteered to test a drug that might not help her. Eleven weeks in, she has a question at seven in the morning. Your site keeps business hours. Questions do not. She is made up, but coordinators tell us every step of this happens constantly.

07:02

She has a question about her pill. The site is closed.

She wakes up sick and picks up her study pill. With breakfast, or on an empty stomach? The coordinator told her 11 weeks ago. The site opens at 9.

07:04

The answer is in a big binder. She can't read it right now.

It is about 30 pages into her consent packet. Her reading glasses are in the bedroom, and she feels too sick to get them.

07:09

The website wants a password. She doesn't know it.

She set it up in March. She gives up. Last time she called the site she waited on hold 20 minutes and got a callback the next day.

07:20

So she guesses. And she never tells anyone.

She takes it with breakfast, because that is what she did yesterday. At her next visit it feels too small to mention. And she does not want the coordinator thinking she is the kind of person who cannot follow directions.

None of this reaches your data. Three months from now she stops answering, and everything she could have told you about whether the drug works leaves with her.

A woman in her late sixties at a kitchen table, holding a capsule and looking at the phone beside her, one hand on a closed binder with her reading glasses on it — She is holding today's dose and cannot remember the instruction.

The problem pharma lives with

This is not one patient. It's every study.

None of this is new. The industry has worked around it for years, because there was nothing else to do. Every number below links to its source.

30%+

Dropout in Phase 3 trials is often over 30%.

Source: National Academies 2010, via Pharmacy and Therapeutics 2013

89% vs 64%

Of patients who finished, 89% said their questions got answered. Of those who quit, 64%.

Source: CISCRP and MedAvante survey 2013, via Advarra

35% vs 16%

Patients who quit were twice as likely to say the consent form was hard to understand.

Source: Same survey

Grade 11.6

The average consent form reads at an 11th-grade level and runs 10 pages.

Source: Larson et al., Clinical and Translational Science 2015

$8M a day

About 80% of trials miss their timeline. A delay can cost up to $8 million a day.

Source: Brøgger-Mikkelsen et al., JMIR 2020

35–61%

Site staff turnover per year. Replacing one coordinator costs $50,000 to $60,000.

Source: SCRS; ACRP 2025

Behind every number here is somebody who had a question and nobody picked up.

Why this has not been fixed

Decentralized trials brought the study to the patient. Then handed them a login.

The promise was that people would not have to travel to take part. What arrived was an app for symptoms, a portal for visits, a device to wear, and a password for every one of them.

The burden never went away. It moved from the clinic to the kitchen table, and it landed hardest on exactly the people least able to carry it. The oldest. The sickest. The ones furthest from a hospital and closest to giving up.

A phone number is the only thing already installed on every device, understood by everyone, and requiring nothing to be learned. It works on a flip phone. It works where there is no broadband. It works at seven in the morning when you are too sick to stand up.

This is what we mean by decentralizing the decentralized trial. Taking the last piece of technology out.

And why it matters beyond your study. Every trial that finishes on time and finishes clean is a medicine that reaches people sooner, and a clearer answer about whether it is safe. Retention is not an operations metric. It is how fast the world gets the next drug.

What it does

Five things it does, on every call.

Each one closes a gap where studies lose patients. The quotes are the questions, in the words patients use.

Answers

Any question about the study, any hour, in her language.

“Am I still supposed to take my own pills?”
Monday 6:40 am

She stops guessing. A dose taken wrong and never mentioned is where quitting starts.

Connects

Dials your site and gets through on her behalf.

“Can somebody move my blood test to Friday?”
Tuesday 4:40 pm

A visit she would have skipped gets rescheduled instead.

Remembers

Every call picks up where the last one ended.

“I told somebody about this last month.”
week 9

A symptom raised once and never followed up is how people stop trusting a study.

Reminds

Calls ahead of visits and fasting labs.

“Nobody told me I wasn't supposed to eat.”
Thursday 8:15 am

Fewer wasted trips. Every wasted trip is a reason to stop coming.

Records

A Part 11 trail, and safety events sent to your desk.

“There's a rash on my arm. Is that something?”
Sunday 9:04 pm

For the first time you can hear what your patients were trying to tell you.

A study coordinator at her desk, phone tucked to her shoulder, surrounded by message slips and patient folders — The other side of every one of these is a coordinator who no longer spends her morning returning voicemails.

What it is worth

Sixty more patients finish. That's $4.5 million saved on one study.

Take a study of 300 patients. Most sponsors plan for 30% to drop out, and replacing one costs about $75,000. The pilot aims for 10%. Run the same arithmetic on your own study.

Both bars are the same 300 people. Red is who leaves. The teal block is the gap between losing 90 and losing 30: 60 patients who stayed because someone answered the phone. Sixty more people in your final analysis.

About these numbers. The 30% and the $75,000 are standard industry planning figures, not ours. The 10% is our target. That is why the pilot runs on your site, against your own history.

Compliance

Built for a regulated study.

A phone line that talks to patients about how they feel is part of your study's safety system. Here is how each rule is handled.

Adverse events

Live

If a patient reports a new symptom, you have to act on it.

Trialpal spots a possible safety event and sends it to your safety desk with a record of what was said and when. It does not judge how serious it is. The patient hears what happens next.

21 CFR Part 11

Live

Records a regulator can trust.

Every call goes into an audit trail that cannot be changed: transcript, every action, time, and software version, each entry linked to the last. Access is controlled, records are signed, and validation paperwork comes with it.

Blinding

Live

It never reveals which treatment a patient is on.

No approved answer mentions treatment groups, and what it remembers is limited to schedules and logistics. That is built into the answer list, not filtered later.

Approved language

Live

Everything said to a patient is IRB approved first.

Trialpal does not make up text. It uses only answers your team wrote and your IRB approved, so the whole script is reviewable before the first call.

Medical advice

Live

It answers questions about the study, not about health.

Dosing times, fasting rules, visits, travel. Anything needing a doctor's judgment goes to your site. Emergencies go to 911 and mental health crises to 988.

Patient data

Live

Phone numbers, transcripts, and the right to be forgotten.

Phone numbers are scrambled with a key only your deployment has before anything is saved. Transcripts are deleted on the schedule you set. If a patient asks to be forgotten, the record is archived, removed from every table, and any scheduled call to them is cancelled.

Pricing

Try it on one site for 90 days.

The pilot costs less than most managers can approve on their own, so there is no procurement cycle. You pick the site. We measure against what it saw before. If you roll out, the pilot fee comes off the price.

Start here

90-day pilot

$45,000

Flat fee, one site

Up to 50 patients
Answers calls 24 hours a day
Connects patients to your site
Measured against the site's own dropout history
Full fee credited if you roll out

Full study licence

$120,000

Per year, plus $50 per patient per month

Every site in the study
Reminder calls before visits and fasting
Remembers each patient across the study
Reports for the whole study

Portfolio agreement

$1M+

Per year, master agreement

As many studies and sites as you run
Connects to your EDC and CTMS
A team just for you
Help with your CRO bids

Who else can pay for this

NIH-funded studies

If your study has an NIH grant, this is an allowable cost.

NIH says so in writing: retention, patient communication, and technology services can be charged to the grant. Your PI can budget it or ask for a supplement.

Source: NIH, Allowable Costs for Participant Inclusion Activities, 2023

NCI supplements

NCI has paid up to $100,000 for tools like this.

It funded supplements for recruitment and retention tools, including AI and telehealth. The last round closed July 2025. Ask your program officer if a new one is open.

Source: NCI Notice NOT-CA-23-071

Small business grants

We can apply for the money, with your site as partner.

NIH SBIR and STTR grants pay companies like us to build and test tools like this. Phase II runs to about $2.1 million. If we win one with your site, the grant pays for your pilot.

Source: NIH SEED, SBIR and STTR basics

If a drug company is paying for your study, this comes out of the study budget. That is why the pilot fits under what most managers can approve on their own.

Your existing vendors

Already use IQVIA, Veeva, or Medidata? Ask them about Trialpal.

You already have a CRO, an EDC, and a CTMS. Adding a vendor alone is the hard way. Ask the ones you already use, and if they have not heard of us, have them email us.

Ask IQVIA.

If IQVIA runs your study, ask your project director whether Trialpal can be part of the site setup.

Have IQVIA reach out to us

Ask Veeva.

If your study runs on Veeva Vault, ask your account team how Trialpal call records can sit next to your study data.

Have Veeva reach out to us

Ask Medidata.

If your study runs on Medidata Rave, ask your account team how Trialpal can feed patient questions into your workflow.

Have Medidata reach out to us

IQVIA, Veeva, and Medidata are trademarks of their respective owners. Trialpal is not affiliated with, endorsed by, or partnered with any of them. We name them only because you already work with them.

Try it

Call it yourself. See what happens.

Use your own phone, the way a patient would. Ask it something a patient would ask. Then ask for the study nurse and listen to what it does when it hits the hold queue. Then imagine doing that while you are sick, on your own, at seven in the morning.

Demo line

1‑800‑555‑0142

Picks up in about a second. No account. Nothing to download.

01Ask what time your next visit is.
02Ask whether you can eat before a fasting draw.
03Ask for the study nurse, then stay on the line.