A Conversation with Brad Hightower

On Tuesday, April 18, Inato co-founders, Kourosh Davarpanah and Liz Beatty sat down for a transparent conversation with Brad Hightower, CEO of Hightower Clinical and host of Note to File Podcast. Hightower hosted a livestream to explore Inato’s mission, better understand how the platform works to benefit sites, and debut a live product demo.

Hightower kicked things off by asking Davarpanah and Beatty to break down the motivation driving Inato to flip the current clinical trial model. Early on in the company, Davarpanah explained, Inato’s team discovered that just 5% of sites run 70% of trials, leaving a huge portion of sites, and importantly their patients, without trial opportunities. Sponsors feel the sites they can trust are the few they’ve worked with before, perpetuating a vicious cycle. Beatty explained, “If [the community sites] can’t get selected, it continues the same problem we have in clinical trials where very few patients can participate in trials or even find out about them.”

The solution the Inato team uncovered was to bridge trust between sites and sponsors by shifting the power over to the sites in the community and placing an emphasis on transparency, diversity, and holistic info, “It was a great opportunity for us to put the sites in the driver seat to get the trials that were the right fit for them,” said Beatty.

1. Transparent Communication

Inato sites have the power to view upcoming trials in sponsor pipelines based on their interest and experience and select and apply for those that are right for them, “The idea here is, as a site you get access to anything and you make the decision on whether you want to spend time on a trial or not,” explained Davarpanah as he demoed the site view of the platform. He broke down the prioritization of increased transparency, where not only can sites anticipate relevant trials down the line, but can decline opportunities that aren’t a right fit and become a collaborative partner in building trial protocols by providing feedback to sponsors early on.

A true back and forth between sites and sponsors to adjust trial protocols is rare but with a step designated for sites to provide feedback, that barrier is diminished and site voices are heard. It’s a fairly new concept, and Hightower expressed concern that it isn’t a good look for sites to be declining opportunities and critiquing trial designs. However, Inato’s team has found that isn’t the case. “Sponsor’s don’t like to hear: Your protocol is difficult. However, it’s very important feedback,” explained Beatty, “I think it’s the main driver for why many sponsors are now coming earlier to us to post their trials instead of waiting for the protocol to be finalized.” That constructive conversation is what winds up allowing more sites to qualify for the trials, ultimately increasing access for patients.

2. Showcasing Diversity

For trials that are a right fit, Davarpanah shared a soon-to-be-released view of the applications sites can submit on Inato’s platform. It starts with showcasing a site’s diversity capabilities right at the top (if applicable). “The way this is structured is, we want the sponsor to get excited and see the potential of the site at the top so they want to scroll down,” he explained.

One of Inato’s main drives is boosting trial diversity. This application shares that information comprehensively by giving sites the space to provide a number of diversity metrics spanning their patient population, comparative census data of their surrounding area, and the diverse makeup of their research team. Additionally, sites can describe their outreach efforts or community engagement, “It’s giving sites an opportunity to put forward what’s unique about them,” said Hightower.

3. Sharing the Full Picture

This holistic site profile allows community sites to truly have a competitive edge in a way they traditionally don't when stacked up against academic sites. When the information they provide sponsors would previously have been limited to raw historical performance data, here sites can provide relevant experience with added context, enabling them to paint a full picture of each trial and where changes were made that affected their ability to perform. “It seems so obvious when you say it out loud but it’s something we’ve been sorely lacking,” Hightower noted.

As the product demo closed, Hightower moved onto questions he received from sites inquiring about Inato’s platform, most importantly: Is it really free? “Sometimes that makes sites suspicious. Are you guys SMO, are you going to be pulling budgets off the top?” he asked. Davarpanah explained that sponsors pay Inato based on the site performance so for sites, it’s entirely free. “So you have a vested interest in the success of sites,” Hightower clarified,  “You want your sites to succeed.” That’s exactly it. Beatty affirmed that putting so much trust in the sites’ performance is a worthwhile investment, “As the sites perform and the sponsors are happy, they unlock more trials to be posted,” going on to describe the future Inato sees this propelling: “We envision a world where sites can get a steady flow of trials from Inato alone.”

To learn more about Inato’s platform and view a demo of these features, check out the full livestream here: How community sites are getting top trials at no cost at Inato