# Pay trial participants for their time, not only their expenses

Source: https://onco.cc/ideas/idea-tr1-pay-participants-for-time/  
OnCo record `idea-tr1-pay-participants-for-time` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Trial visits take hours and cost people wages. Paying a fair hourly rate for time spent beyond normal care would make trials possible for those who cannot afford unpaid days off.

## Summary

Participants receive a wage-equivalent payment for research-only time (extra visits, procedures, questionnaires), set to a local living wage, disclosed in consent, and paid regardless of completion to avoid coercion to continue. Ethics guidance would treat payment for time as ethically required rather than suspect. Test whether it shifts who enrols.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Offering wage-equivalent payment for time increases enrolment of working-age and lower-income patients without increasing early withdrawal or misreporting of eligibility.
- Rationale: Healthy-volunteer trials pay for time routinely; the refusal to pay cancer patients rests on a concern about undue influence that empirical studies have not supported. Lost wages are cited as a barrier as often as travel.
- Proposed test: Randomise sites within a large trial to offer or not offer time payment; compare enrolment demographics, refusal reasons and retention.
- Maturity: speculative
- Actor: policy

## Sources

- FDA: Payment and Reimbursement to Research Subjects: https://www.fda.gov/regulatory-information/search-fda-guidance-documents/payment-and-reimbursement-research-subjects

## Connected records

- bottlenecks: [Trials do not represent the people who get cancer](https://onco.cc/bottlenecks/b-trial-diversity/), [Trials enrol too few, too slowly](https://onco.cc/bottlenecks/b-trial-enrolment/)
- roadmaps: [Trial modernisation roadmap: the randomised trial → platforms and adaptive designs → decentralised, pragmatic and always-on](https://onco.cc/roadmaps/trial-modernisation-roadmap/)

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