Impact of clinical trials on the cost of cancer care.
BACKGROUND
Empirical evidence on the economic impact of cancer clinical trials is in short supply, but it is widely assumed that clinical trials add at least 10% to overall costs.


OBJECTIVE
To estimate how much, if at all, trial enrollment increases the use of scarce resources in treating breast, lung, lymphoma, and ovarian cancer patients.


METHODS
A profile of the cumulative charges for all inpatient and outpatient hospital care received by a sample of patients over an observation period beginning at diagnosis and continuing for upwards of 44 months postdiagnosis. Patients are classified by whether they were enrolled on an IRB-sanctioned research protocol and, if so, by the type of protocol. Both univariate and multivariate statistical tests are conducted to appraise whether cumulative charges differ between patients who were enrolled on key types of protocols and those who were not.


METHODS
Approximately 1,900 breast, lung, lymphoma, and ovarian cancer patients treated at a single center.


METHODS
Clinical endpoints and demographic, disease, and therapy characteristics of patients that drive treatment costs.


RESULTS
Controlling for demographic and disease characteristics, initial therapy, and key endpoints, the net effect of trial participation on cumulative charges for hospital inpatient and outpatient care is never significantly positive at conventional confidence limits. This result is found for each of the four patient groups and three types of protocols encompassed by this analysis.


CONCLUSIONS
Support for clinical trials by health care payers does not necessarily risk adding significantly to the cost of cancer care.
Chirikos
T N
TN
H. Lee Moffitt Cancer Center & Research Institute, University of South Florida, Tampa, Florida 33612-9497, USA. chirikos@moffitt.usf.edu
Ruckdeschel
J C
JC
Krischer
J P
JP
D000368:Aged; D016009:Chi-Square Distribution; D002986:Clinical Trials as Topic; D003365:Costs and Cost Analysis; D005260:Female; D017722:Hospital Charges; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics* / Q000628:therapy*; D012044:Regression Analysis