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Amidst the daily demands of running a mid-sized pharmaceutical marketing research agency, I still prioritize conducting interviews nearly every day. That may be uncommon in our industry, but I wouldn’t have it any other way. Over the course of more than 30 years in this field, I have had the privilege of engaging with thousands of respondents—top scientific leaders, researchers, physicians, nurses, patients, caregivers, treatment advocates, administrators, and payers. These conversations, in my view, are the most effective way to deeply understand the real challenges our clients face and to generate insights that drive informed, strategic decision-making.
Yet, despite the depth and nuance that high-quality research provides, ThinkGen—and the industry at large—continues to wrestle with a persistent and exasperating challenge: healthcare providers (HCPs) and patients misrepresenting themselves on screeners to gain entry into studies for which they simply do not qualify.
Two weeks ago, while meeting with a long-time client—a senior executive at a pharmaceutical company specializing in ultra-rare diseases—she called it what it is: fraud. That’s a strong word, a harsh word, but an accurate one. This issue is not new, but it is evolving—becoming more sophisticated and, in some ways, more subtle. At its core, fraudulent respondents erode the integrity of our data, distorting the foundation of decision-making in an industry where precision and accuracy are paramount. If the wrong voices infiltrate a study, whether qualitative or quantitative, the insights we deliver—no matter how meticulously analyzed—can be flawed.
This is particularly problematic in rare disease research or business development settings, where small sample sizes magnify the weight and value of each conversation, making every respondent’s input disproportionately influential.
I began my career in the phone room, recruiting managed care decision-makers, so I understand the immense pressure that fielding agencies face. The challenge is relentless: balancing the need to fill sample quotas efficiently while ensuring that only qualified participants are included in studies. This is no easy feat, especially as the fraudsters become increasingly adept at gaming the system. But as an industry, we must take a hard look at how we are combatting this challenge. What safeguards are we implementing to protect the integrity of our research? How can we work collaboratively to refine our processes, ensuring that the data we collect truly reflects the perspectives of those with the relevant expertise and experience?
I write this not as a detached observer, but as someone who thrives on engaging with the right respondents—who finds professional fulfillment in uncovering real insights from the right people. And conversely, as someone who experiences a deep sense of frustration when an interview turns out to be with someone who simply does not belong in the study. It is time for a candid and constructive conversation about how we, as an industry, tackle this persistent issue—not to assign blame, but to find meaningful solutions.
My first encounter with respondent fraud happened early in my career as a full-time moderator conducting marketing research on antiviral treatments, particularly in HIV/AIDS and Hepatitis. At the time, HIV treatment paradigms were becoming pretty well-defined, with a handful of antiretroviral (ARV) therapies forming the standard of care—making it relatively easy to identify fraud.
I would start interviews with straightforward questions about treatment approaches, ones any legitimate HIV-treating specialist could answer effortlessly. Yet, time and again, I encountered doctors whose responses contradicted established guidelines. One might confidently state they prescribe “combination therapy,” citing Truvada as their first-line agent—an immediate red flag. A dual therapy when the standard of care calls for a triple ARV combination, like Atripla, Truvada + a PI, or Truvada + Isentress? Either they were committing malpractice or, more likely, they weren’t treating HIV at all. Their outdated drug choices, vague responses, and hesitation only confirmed what I had begun to suspect: many of these so-called specialists had no real experience managing people living with HIV.
This led me to a question I have asked myself countless times since: why do healthcare professionals—people we generally trust—misrepresent themselves in market research studies? These are individuals who have taken an oath to do no harm, who are expected to act with integrity in their clinical practice, and yet, many were willing to stretch the truth or outright lie on screeners just to qualify for a study. Some may have viewed it as a harmless way to make a few hundred bucks. Others, I suspect, may have rationalized their participation, believing that their indirect involvement in patient care was "close enough" to qualify. And then there were those who, once confronted with their own misalignment, would backtrack, attempting to reframe their role in ways that might still make them seem credible.
But another, more uncomfortable possibility also exists—one that speaks to how some HCPs perceive the pharmaceutical industry, and by extension, the marketing research agencies that support it. There are doctors who look at what we do and see little value in it. Some perceive pharma-sponsored research as little more than a trivial marketing exercise, failing to recognize its role in shaping meaningful advancements in medicine; or in informing key decisions around educating customers. Others may harbor cynicism about the industry as a whole, seeing it as completely profit-driven and disconnected from patient care. If they believe the system itself is flawed or even corrupt, then misrepresenting themselves on a screener may not feel like a real ethical violation. To them, it's not fraud in the moral sense—it’s just playing along with a game they don’t respect.
However, regardless of motivation, the impact for us remains the same: unreliable data that skews insights and compromises decision-making. And in an industry where research influences everything from early-stage drug development go/no-go, to multi-million dollar campaign decisions, to patient access and support, the consequences of that deception are far from insignificant.
Respondent fraud is no secret in health care market research. It’s an enduring challenge, not because of negligence but because financial incentives create an inevitable draw for bad actors. To their credit, many panel providers and recruiters are actively working to combat fraud. Digital fingerprinting, duplicate detection, and open-ended validation questions are now standard defenses, and some firms maintain proprietary databases—so-called “DNR lists”— to identify repeat offenders. When I spoke with a representative from a top panel provider firm last week, it was clear that fraud detection is an ongoing priority. Yet, despite these safeguards, fraudulent respondents continue to slip through. This raises an important question: Are these measures truly effective, or is a certain degree of fraud just an unavoidable reality of the research process?
Recruitment firms face immense pressure to deliver qualified participants on tight timelines. Screening rigor must be balanced with speed, and in a deadline-driven environment, feasibility often trumps perfection. We’ve all experienced it—I once had to recruit 10 managed care P&T committee members in 48 hours. Some firms take extra precautions, such as verifying HCPs against medical licensing databases, but this isn’t always standard. Panel providers, whose business model relies on scale, often prioritize broad reach over deep vetting. And let’s be honest—this is not a high-margin business. Even with best practices in place, fraudsters have become adept at gaming the system. I’ve had so-called “experts” in a given disease state who, when interviewed with the webcams off, were clearly reading from Medscape or UpToDate rather than speaking from firsthand knowledge.
So where do we go from here? This isn’t just a recruiter problem—it’s an industry-wide issue, and we all have a role to play. How do we refine verification processes without making screeners so rigid that we alienate the right participants? Can AI-driven behavioral analysis help flag inconsistencies in real-time? Is there a way for agencies to share data on known fraudsters without running into competitive roadblocks? The industry has made progress, but if fraudulent respondents continue to undermine the integrity of our insights, then clearly, we need to do more. It’s time for a bigger conversation—not just about what’s been done, but about what’s truly possible.
Participant recruitment in marketing research is a lot like fishing. You cast a carefully designed screener into a pool of potential respondents, hoping to net the right participants—those with the real-world experience and expertise to provide meaningful insights to inform sound decision-making. But just as any seasoned angler knows, not everything that bites is worth keeping. Mixed in with the legitimate catches are the ones you don’t want: the bottom-feeders, the ones who don’t belong in the net, the ones that, if you’re not paying attention, can contaminate the entire haul.
But why do so many respondents—particularly physicians—feel comfortable misrepresenting themselves? Fraudulent participants don’t always view what they’re doing as deception. Some rationalize their actions, seeing themselves as close enough to the target participant profile that their opinions still matter. Others may not respect the research process, dismissing it as just another industry exercise designed to help pharmaceutical companies sell more drugs.
And then there’s the financial incentive. Stepping back, the reality of the situation is that many HCPs, particularly those in private practice, are under mounting financial and administrative pressure. Reimbursement rates have stagnated, workloads have increased, and for some, an easy honorarium for a 30-minute interview is simply too good to pass up—even if it means stretching the truth to qualify. If these same professionals had greater respect for the industry, or if they felt fairly compensated for their time in clinical practice, would they still be so willing to game the system?
Perhaps this essay raises more questions than it answers. How do we elevate the perception of market research so that the right respondents—those with genuine expertise—see value in participating honestly? How can we strike a balance between maintaining rigorous verification yardsticks while at the same time making participation seamless for legitimate professionals? And perhaps most importantly, how do we ensure that research remains a tool for truth rather than an exercise undermined by those looking for a quick payout?
Fixing this problem will require more than just better fraud detection—it demands a shift in how our industry engages with and is perceived by the very people we rely on for insights.
