For clinical trials, cold chain logistics is of ever-increasing importance. Tea Rajic of rfXcel explores the implications of The Internet of Things (IoT), 21st century transport and the cold chain, including how to design the cold chain from day 1, and transforming clinical trials beyond the cold chain. She concludes that pharmaceutical companies should plan cold chains for clinical trials long before research begins, especially for advanced treatments such as gene therapy, cell therapy and tissue engineering.