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Updated: Jun 26, 2026

An R-Based Landscape Validation of a Competing Risk Model
Published on: September 16, 2022
Quantifying the Financial Return on Investment of Risk-Based Quality Management Implementation in Clinical
Abigail Dirks1, Sylviane de Viron2, Kenneth McFarlane3
1Tufts Center for the Study of Drug Development, Tufts University School of Medicine, Boston, MA, USA. Abigail.Dirks@tufts.edu.
Background:
Despite widespread receptivity to risk-based quality management (RBQM) principles, adoption has been limited as drug development stakeholders have lacked quantitative evidence demonstrating return on investment (ROI).
Methods:
Two assessments were conducted to estimate the ROI of RBQM. (1) Clinical trial level ROI was derived by analyzing monitoring cost efficiencies and clinical phase duration reductions under a 10% source data verification (SDV) scenario. (2) Program-level ROI was derived using an expected net present value (eNPV) modeling approach. Both analyses included data based on actual RBQM use in 18 recently completed oncology trials, as well as published and proprietary industry benchmarks.
Results:
RBQM use was associated with reductions of 8-19% in clinical phase durations and monitoring cost reductions of up to 18% under a 10% SDV scenario. Total clinical trial ROIs ranged from $3.2 million (phase 1) to $18.9 million (phase 3), corresponding to ROI multiples of 6× to 23×. Program-level eNPV gains ranged from $3.8 million in phase 1 to $13.8 million in phase 3 corresponding to ROI multiples of 4× to 14×.
Conclusions:
The ROI demonstrated at the individual clinical trial level and at the development program level provides a compelling business case for adopting RBQM particularly given alignment with ICH E6 R3 guidelines encouraging risk-based approaches supporting clinical trial planning and execution. Study findings indicate that RBQM-supported oversight not only improves data quality and risk detection but also represents a strategic investment that can help optimize resource allocation, increase development efficiency and speed, and enhance portfolio productivity.
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