The past 20 years has seen the addition of electronic data capture (EDC) through devices, risk-based monitoring and – more recently – flexible clinical trials such as decentralized trials. Although it may be easiest to not change and keep running clinical trials the same way, the cost is also incredibly expensive. Several years ago, Tufts Center for the Study of Drug Development found that 11% of clinical trials fail to recruit one patient. Given that the cost of running a clinical trial is often in the millions, failed clinical trials are costing institutions major portions of their research budget. It’s time to break the cycle of insanity in clinical trials.