In the world of drug development, it is typically the outcomes of phase 3 clinical trials that get the most attention. With the possibility of game-changing treatments for a myriad of diseases, they garner the most headlines, especially as the world waits on vaccines and effective treatment for the coronavirus disease 2019 pandemic.

But what happens during the early phase of testing? On today’s episode of Managed Care Cast, we speak with Jill A. Fisher, PhD, author of a new book, Adverse Events: Race, Inequality, and the Testing of New Pharmaceuticals. Her research took her inside clinical testing sites for phase 1 drug studies, a veiled world where healthy participants agree to spend days or weeks in a locked facility receiving an active ingredient or placebo. She interviewed participants, research staff, and others, and delves into the societal and economic forces that compel people—typically Black men in their 20s, 30s and 40s—to enroll repeatedly in phase 1 studies.