Logistics Strategies to Reduce Costs in Decentralized Clinical Trials

In recent years, interest in decentralized clinical trials (DCTs) has grown significantly. This is partly due to their ability to boost enrollment and retention rates, as well as their capacity to reach participants beyond the limits of traditional clinical trial designs. However, despite these advantages, many companies are concerned about the additional costs DCTs can incur. 

While DCTs offer substantial benefits, they often require coordination with multiple logistics partners, which can increase operational costs. This leads many sponsors to wonder how to capture DCT advantages without driving up expenses. Rethinking how DCT logistics are structured and managed can offer a solution. But first, we need to explore where the added costs arise.

Complexity Adds Cost

In 2022, the Tufts Center for the Study of Drug Development published its assessment of the financial value of DCTs. Researchers found significant value from DCT methods in phase II and phase III trials for both large and small molecule drugs. They identified three key drivers of value: shorter clinical phase cycle times, reduced screen failure rates, and fewer substantive protocol amendments. These factors resulted in a return on investment (ROI) nearly five times greater than the additional cost of implementing DCT elements. Yet, external disruptions and growing operational complexity can quickly erode these gains if logistics are not carefully managed.

For example, in early 2025, Medpath reported that approximately 80 percent of trials missed enrollment targets, often due to delays. One explanation is the vulnerability of global shipping and air routes to rising cases of extreme weather and other regional instabilities. In addition, the growing interest in biologics has increased trial complexity, due to the need for strict temperature control, stringent chain-of-custody, and rapid delivery of these high value and highly sensitive therapies. This in turn compounds the financial risks associated with disruptions. As a result, the cost of running a DCT has risen sharply, up 30 percent since 2018. 

How Integrated Logistics Partners Protect DCT ROI

Despite higher costs, companies continue to embrace DCT methodologies because, when managed effectively, they offer a real competitive advantage. The Tufts study suggested that DCTs can reduce the duration of phase II and III trials by at least 10 percent, or up to three months per phase. This translates to an ROI of about five times for phase II and even higher for phase III trials. 

However, fragmented logistics, including transport handled by multiple logistics service providers, can quickly erode these gains. A critical issue is the complexity of logistical decisions—such as transport, customs clearance, and labeling—which multiply when several companies are involved. The challenge is amplified for biologics, in which fragile biological materials must be transported across regions with varying climates, time zones, customs procedures, and regulatory requirements. Using a single, integrated, logistics partner, with an established presence across Asia, Europe, and North America, can significantly reduce costly delays caused by cross-regional bureaucracy. 

Overcoming Delays

As mentioned previously, delays are a major contributor to rising operational costs in DCTs. A logistics partner with a strong local presence and relationships can significantly reduce customs delays and transportation challenges. For example, a logistics service provider with the ability to coordinate locally can prepare documentation and arrange customs clearance ahead of shipment arrival, greatly reducing time spent at borders.

Moreover, strong relationships with border authorities can help logistics providers anticipate required changes, allowing adjustments without delaying shipments. Beyond paperwork, logistics providers can collaborate directly with airlines to minimize disruptions, such as securing flights for large or heavy cargo. To this end, even major international pharmaceutical companies can benefit from partners with deep transportation expertise.

When Shipments Get Grounded

These advantages aren’t just theoretical—they’ve been proven in real-world situations. A recent case study illustrates how the value of an experienced, well-connected logistics partner can rescue a stranded shipment and meet urgent trial deadlines. A leading international pharmaceutical company needed to move a large, critical shipment of safety equipment from the United Kingdom to the United States (U.S.) within a tight timeframe. The shipment—comprising just seven pallets but weighing a staggering 8,160 kg—initially stalled in Luxembourg when the original contractor struggled to find an aircraft willing to take such heavy cargo. 

With only four days left before the deadline, the pharmaceutical company turned to Yourway for help. The logistics provider coordinated custody release and U.S. customs clearance. It then found a cargo aircraft willing to offload its existing cargo to accommodate the shipment. These actions required strong industry networks and knowledge to overcome bureaucratic hurdles. Even then, timing remained critical. The original plan to fly into New Jersey would have been too late. So, Yourway rerouted the shipment to Chicago and arranged immediate trucking for the final 800 miles to New Jersey. This swift action ensured on-time delivery and highlights the value of logistics partners with deep industry relationships and extensive cross-regional experience.

Just-In-Time Labeling Protects Privacy

Modern DCTs often involve autologous therapies—treatments made from a patient’s own cells or tissues, which are collected, modified or processed, and then returned to the same patient. These therapies require strict chain-of-identity oversight to protect participant privacy. Protocols or participant changes can create high costs due to the need to relabel materials. Working with a logistics partner that offers just-in-time labeling effectively offsets these costs by providing invaluable flexibility—allowing labels to be printed and applied only when needed, reducing waste and minimizing errors, all while protecting patient privacy. 

Beyond autologous therapies, just-in-time labeling also offers broader advantages for decentralized trials. Because participant engagement can vary widely across different sites and times, this service can adapt to shifting demand efficiently. When integrated with transport and courier services under the same logistics partner, just-in-time labeling streamlines the entire process, making patient engagement quicker, more seamless, and cost-effective.

Local Knowledge Ensures Kits are Complete

DCTs often take place outside traditional clinical sites, where standard medical equipment may be scarce or unavailable. Even minor omissions—such as the wrong type of swab, an incompatible charger for a medical device, or a wearable in the wrong size—can delay participation by days or weeks. These delays frustrate participants, disrupt schedules, and can lead to costly reshipments or dropouts.

A logistics partner with strong local knowledge can anticipate and prevent these issues by sourcing region-specific supplies in advance, ensuring all components meet regulatory requirements, and tailoring kits to climate, cultural, and language needs. This proactive approach keeps trial timelines on track, minimizes waste, and improves the participant experience—directly supporting cost control and retention goals.  

The Value of Real-Time Tracking

Modern therapies are high-value and often sensitive to temperature and timing. As referenced earlier, biologics of all types often require strict temperature control, sometimes involving liquid nitrogen or specialized refrigeration. Risks multiply when temperatures must be maintained over multiple shipping locations and transfers. With the high value of modern therapies, sponsors can ill-afford temperature excursions, delays, or damage.

Real-time tracking technology is an effective risk management tool, improving oversight of high-value, temperature-sensitive therapies and enabling rapid problem resolution. For example, if an investigational product arrives at a patient’s home with a recorded temperature deviation, the tracking data can be assessed in real-time by a home health professional. This allows the issue to be addressed on the spot, preventing unnecessary cancellations and ensuring continuity of care. 

Making Trials More Inclusive

High screen failure rates—the percentage of potential participants who fail eligibility criteria or opt out of clinical trials—are common due to logistical burdens. DCTs help reduce these failure rates and broaden participation to include more diverse populations. Partnering with a regional logistics expert streamlines participant coordination and meets complex needs.

Likewise, having a partner with a local presence and knowledge of languages, in addition to good relationships with nearby sites and stakeholders, further improves efficiency. For trials shipping directly to patients, a logistics partner can arrange deliveries to match patient schedules, including workplace drop-offs, making participation easier and improving retention.

Bringing It Home

DCTs are one of the most important methodological advancements in clinical research. They have the power to boost reach, retention and ROI. However, costs can quickly escalate when logistics become complicated.

Managing those complexities effectively starts with choosing a logistics partner that can track materials in real time and quickly alert sponsors to emerging issues to ensure that high-value materials are not irrevocably damaged. Such a partner must also be agile, with wide networks and enough experience to troubleshoot transportation issues as they arise. Finally, the partner needs to maintain a strong local presence, which can help lower costs by streamlining protocols, meeting customs demands and overcoming the complexities of at-home trials. 

The simplest method is often the best. Choosing a single logistics partner capable of scaling services from local to global levels is the most effective way to manage costs during DCTs. As DCTs become increasingly popular, finding the right logistics partner is essential to balancing risk and reward across clinical trials.

References

https://pmc.ncbi.nlm.nih.gov/articles/PMC9473466

https://trial.medpath.com/news/f9da185685ce1a58/clinical-trial-complexity-drives-30-cost-increase-industry-faces-growing-challenges-in-drug-development