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Optimizing
Sponsor/CRO
Relationships
Introduction: Kristen Snipes
Experience:
• 18 years in Drug Development
• 13 years experience at CRO in various roles in both
clinical operations and project management
• Over 10 years of project management experience
• Experience managing analytical method development,
formulation, IND filings (including CMC) and Phase 1-4
clinical trials at a Sponsor Company
• Focus in CNS, cardiology, and dental indications
Introduction: Jamie Arnott
Experience: 22 years in healthcare as a
practitioner and in clinical research
• 12+ years in project management
• 10 years experience at CRO in clinical operations and
project management
• 6 years experience as Director, Clinical Trial Operations at
a Sponsor company
• Focus in oncology, orphan indications, and infectious
diseases
• Experience managing and providing oversight for all
clinical activities for multiple concurrent INDs
Overview
The Ideal
Relationship
Communication The Conversation
Oversight Reporting
Financial
Management
Case Studies Keys to Success
Key Factors in CRO- Sponsor
Relationships
Communication
Reports
Financial Management
Oversight
Ideal Relationship
Characteristics that make up good,
healthy working relationships
Trust
Mutual respect
Mindfulness
Welcoming diversity
Open communication
Single point of contact
Manners/Business Etiquette
Be on time
Be responsive and reliable
Follow through
Appropriate technology use
Business writing
Phone usage
Body language
Sponsor Needs
Clear communication pathways
Points of escalation
Timelines
Risk identification
Confirmation of key staff
Transparency
Information for upward reporting
CRO Needs
Clear directives
Point of contact
Unified messaging
Collaboration
Identification of stakeholders and decision makers
Whose SOPs/processes are we following?
Communication
Method
Format requested by Sponsor
Concise and accurate
Appropriate frequency
Preparing for the Negotiation
Consider communication styles and adapt if necessary
Define the exact outcome you want
Consider the likely desired outcome of the person you’re working with
• What do they say they want? What do they really want?
Consider the underlying interests of those involved
• Why do they want what they want?
• What lies behind the position they are stating?
Create a list of the interests of those involved and prioritize
How to Identify Interests
Understand each
perspective
Listen
Ask Open Ended
Questions
• Why? What? How?
Listen
Consider which
interests might
stand in the way of
agreement
Listen
Open Ended Questions
Why is that
important to you?
What is important
to you about
that?
What will having
that do for you or
the project?
What is
meaningful to
you about having
that?
Why do you think
that would be
best?
What impact will
that have on you
or the project?
The Conversation
Establish
Rapport
Create comfortable
environment for
discussion
Build Trust
Discuss the
Problem
State your
understanding of the
situation
Ask open-ended
questions to gain
understanding
Start with general
questions to find
common interests
Demonstrate your
understanding of the
interests of others
Propose
solutions
Suggest solutions that
address key interests
Be clear about options
Remain open to fresh
ideas
Advocate your interests
and listen
The Conversation, continued
Establish
Agreement
Identify general
solutions both
can agree to
Discuss and
agree to specific
actions
Ensure goals are
SMART
Confirm
Commitment
Define actions
needed and who
is responsible
Agree how to
monitor progress
and evaluate
Conclude
Conversation
Highlight
successes of
discussion
Emphasize
common
interests that
lead to
conclusion
What if something goes wrong?
• Ask more general open questions
• Go back to common ground
No Agreement
• Ask other person for their assessment
• Suggest continuing another time
Conversation
seems stuck
• Pause; take a deep breath
• Consider ending conversation
Discussion
becomes
heated
Communication Summary
Identify objectives/task owners
Give input/feedback
– Don’t always agree
– Alternative options
– Be involved in developing the study plan/strategy
Be transparent
Be prepared to say no if a request will NOT be met
– Don’t say yes because it’s easy at the time
– Evaluate alternative options
– Evaluate what is limiting the team from saying yes
Be respectful and professional
Oversight
ICH E6
Sponsor
Requirements
Balance
Project plans
Visibility is key
for all parties
Documentation of Oversight
Communication:
• Team effort
• Not micromanaging
• Not clean handoff and walk away
• Reassess Project Plans
Documentation:
• How will you demonstrate?
• How is this proven to regulatory
authorities?
• Escalation and risk identification
• Revise Project Plans as assumptions
change
Reporting
What’s
standard
What’s needed
Frequency Format
Reporting Process
Determine study reporting requirements
Implement study reporting process
Complete periodic re-evaluation of study
reports
Adjust reporting frequency or content
Implement revised reporting process
Financial Management
Pharmaceutical R&D Spending
• A recent estimate took large pharma’s R&D budgets divided by drugs
approved 1997-2011 give costs ranging from $3.7 Billion per Drug (Amgen)
to $11.8 Billion per Drug (AstraZeneca) InnoThink Center for Research in Biomedical Innovation
$11.8 BILLION !
Budget
Review assumptions in study budget
Be aware of key program drivers
Identify stakeholders and process for change
orders
Transparency and clear communication
Case Study: PM Parental Leave
• Good standing relationship in place
between PM at Sponsor and CRO
• PM to head out of parental leave
• Interim PM assigned
Change in Primary contact for 6
months
Case Study: To the Rescue!
• CRO has been awarded a rescue study
pulled from another CRO
• Timelines are crunched
• Site frustration
• Site confusion regarding point of contact
for study activities
• Sponsor unhappy
Sponsor awards rescue study
Case studies: Site Selection
• Needing to add sites to boost
enrollment
• Budget implications
• Timeline impact
Enrollment boost needed
Case Study: Unfavorable
Outcomes
• After 2 year enrollment and treatment,
data results are released and aren’t
favorable
• Relationship critical to weather bumpy
results
• Confidence in execution and data
deliverables
• Work to determine additional analyses
required
Study Results are released
Case Study: Client Management
• SIVs before IRB approval
• Site staff may differ
• Sites forget study once it is time to enroll
• Retraining = $
• Lack of focus on your study = $
• Create study plans with draft protocol
• Rework = $
• Confusion/mistakes
Impact when Sponsors do things out
of order
Keys To Success
Make personal connections
Active listening
Stay informed
Key factors
– Cost
– Quality
– Time

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Optimizing Sponsor/CRO Relationships

  • 2. Introduction: Kristen Snipes Experience: • 18 years in Drug Development • 13 years experience at CRO in various roles in both clinical operations and project management • Over 10 years of project management experience • Experience managing analytical method development, formulation, IND filings (including CMC) and Phase 1-4 clinical trials at a Sponsor Company • Focus in CNS, cardiology, and dental indications
  • 3. Introduction: Jamie Arnott Experience: 22 years in healthcare as a practitioner and in clinical research • 12+ years in project management • 10 years experience at CRO in clinical operations and project management • 6 years experience as Director, Clinical Trial Operations at a Sponsor company • Focus in oncology, orphan indications, and infectious diseases • Experience managing and providing oversight for all clinical activities for multiple concurrent INDs
  • 4. Overview The Ideal Relationship Communication The Conversation Oversight Reporting Financial Management Case Studies Keys to Success
  • 5. Key Factors in CRO- Sponsor Relationships Communication Reports Financial Management Oversight
  • 6. Ideal Relationship Characteristics that make up good, healthy working relationships Trust Mutual respect Mindfulness Welcoming diversity Open communication Single point of contact
  • 7. Manners/Business Etiquette Be on time Be responsive and reliable Follow through Appropriate technology use Business writing Phone usage Body language
  • 8. Sponsor Needs Clear communication pathways Points of escalation Timelines Risk identification Confirmation of key staff Transparency Information for upward reporting
  • 9. CRO Needs Clear directives Point of contact Unified messaging Collaboration Identification of stakeholders and decision makers Whose SOPs/processes are we following?
  • 10. Communication Method Format requested by Sponsor Concise and accurate Appropriate frequency
  • 11. Preparing for the Negotiation Consider communication styles and adapt if necessary Define the exact outcome you want Consider the likely desired outcome of the person you’re working with • What do they say they want? What do they really want? Consider the underlying interests of those involved • Why do they want what they want? • What lies behind the position they are stating? Create a list of the interests of those involved and prioritize
  • 12. How to Identify Interests Understand each perspective Listen Ask Open Ended Questions • Why? What? How? Listen Consider which interests might stand in the way of agreement Listen
  • 13. Open Ended Questions Why is that important to you? What is important to you about that? What will having that do for you or the project? What is meaningful to you about having that? Why do you think that would be best? What impact will that have on you or the project?
  • 14. The Conversation Establish Rapport Create comfortable environment for discussion Build Trust Discuss the Problem State your understanding of the situation Ask open-ended questions to gain understanding Start with general questions to find common interests Demonstrate your understanding of the interests of others Propose solutions Suggest solutions that address key interests Be clear about options Remain open to fresh ideas Advocate your interests and listen
  • 15. The Conversation, continued Establish Agreement Identify general solutions both can agree to Discuss and agree to specific actions Ensure goals are SMART Confirm Commitment Define actions needed and who is responsible Agree how to monitor progress and evaluate Conclude Conversation Highlight successes of discussion Emphasize common interests that lead to conclusion
  • 16. What if something goes wrong? • Ask more general open questions • Go back to common ground No Agreement • Ask other person for their assessment • Suggest continuing another time Conversation seems stuck • Pause; take a deep breath • Consider ending conversation Discussion becomes heated
  • 17. Communication Summary Identify objectives/task owners Give input/feedback – Don’t always agree – Alternative options – Be involved in developing the study plan/strategy Be transparent Be prepared to say no if a request will NOT be met – Don’t say yes because it’s easy at the time – Evaluate alternative options – Evaluate what is limiting the team from saying yes Be respectful and professional
  • 19. Documentation of Oversight Communication: • Team effort • Not micromanaging • Not clean handoff and walk away • Reassess Project Plans Documentation: • How will you demonstrate? • How is this proven to regulatory authorities? • Escalation and risk identification • Revise Project Plans as assumptions change
  • 21. Reporting Process Determine study reporting requirements Implement study reporting process Complete periodic re-evaluation of study reports Adjust reporting frequency or content Implement revised reporting process
  • 23. Pharmaceutical R&D Spending • A recent estimate took large pharma’s R&D budgets divided by drugs approved 1997-2011 give costs ranging from $3.7 Billion per Drug (Amgen) to $11.8 Billion per Drug (AstraZeneca) InnoThink Center for Research in Biomedical Innovation $11.8 BILLION !
  • 24. Budget Review assumptions in study budget Be aware of key program drivers Identify stakeholders and process for change orders Transparency and clear communication
  • 25. Case Study: PM Parental Leave • Good standing relationship in place between PM at Sponsor and CRO • PM to head out of parental leave • Interim PM assigned Change in Primary contact for 6 months
  • 26. Case Study: To the Rescue! • CRO has been awarded a rescue study pulled from another CRO • Timelines are crunched • Site frustration • Site confusion regarding point of contact for study activities • Sponsor unhappy Sponsor awards rescue study
  • 27. Case studies: Site Selection • Needing to add sites to boost enrollment • Budget implications • Timeline impact Enrollment boost needed
  • 28. Case Study: Unfavorable Outcomes • After 2 year enrollment and treatment, data results are released and aren’t favorable • Relationship critical to weather bumpy results • Confidence in execution and data deliverables • Work to determine additional analyses required Study Results are released
  • 29. Case Study: Client Management • SIVs before IRB approval • Site staff may differ • Sites forget study once it is time to enroll • Retraining = $ • Lack of focus on your study = $ • Create study plans with draft protocol • Rework = $ • Confusion/mistakes Impact when Sponsors do things out of order
  • 30. Keys To Success Make personal connections Active listening Stay informed Key factors – Cost – Quality – Time