Certified Clinical Research Associate (CCRA) Practice Exam 2026 – Complete Preparation Guide

The correct choice, recruitment efforts, is included in the non-refundable start-up fees because these costs are essential for initiating a clinical trial. Recruitment efforts involve everything from advertising to patient outreach and engagement strategies aimed at ensuring that the study can enroll the necessary number of participants. These expenses are incurred prior to the study's commencement and are typically considered part of the investment in the trial, making them a fixed cost that will not be returned once the study is initiated.

In contrast, subject travel costs, post-study publication costs, and monitor's travel expenses are generally variable and contingent on specific activities throughout the trial or post-trial processes. These costs can fluctuate based on study needs, patient participation, and the extent of monitoring required. Therefore, they are not classified as non-refundable start-up fees, which are more predictable and fixed at the initial stages of study preparation.