Patient and site experiences are the key to understanding why clinical trial patient retention is challenging. Analyzing feedback from Medidata’s Patient Insights Program, the Medidata SiteTech Board powered by the SCRS (Society for Clinical Research Sites), and the extensive 2023 industry survey conducted by Industry Standard Research (ISR) on behalf of Medidata, we can share insights that shape the patient, site, and sponsor experience regarding the financial aspects of patient-level engagement.