Costs and benefits of the national cancer institute central institutional review board.
OBJECTIVE
In 2001, the National Cancer Institute (NCI) formed the Central Institutional Review Board (CIRB) to conduct a single human subjects review for its multisite phase III oncology trials. The goal of this study was to assess whether NCI's CIRB was associated with lower effort, time, and cost in processing adult phase III oncology trials.


METHODS
We conducted an observational study and compared sites affiliated with the NCI CIRB to unaffiliated sites that used their local IRB for review. Oncology research staff and IRB staff were surveyed to understand effort and timing. Response rates were 60% and 42%, respectively. Analysis of these survey data yielded information on effort, timing, and costs. We combined these data with CIRB operational data to determine the net savings of the CIRB using a societal perspective.


RESULTS
CIRB affiliation was associated with faster reviews (33.9 calendar days faster on average), and 6.1 fewer hours of research staff effort. CIRB affiliation was associated with a savings of $717 per initial review. The estimated cost of running the CIRB was $161,000 per month. The CIRB yielded a net cost of approximately $55,000 per month from a societal perspective. Whether the CIRB results in higher or lower quality reviews was not assessed because there is no standard definition of review quality.


CONCLUSIONS
The CIRB was associated with decreases in investigator and IRB staff effort and faster protocol reviews, although savings would be higher if institutions used the CIRB as intended.
Veterans Affairs Palo Alto Health Care System and Department of Health Research and Policy, Stanford University School of Medicine, Menlo Park, CA 94025, USA. todd.wagner@va.gov
Todd H
TH
Wagner
Christine
C
Murray
Jacquelyn
J
Goldberg
Jeanne M
JM
Adler
Jeffrey
J
Abrams
D000328:Adult; D035843:Biomedical Research / Q000191:economics* / Q000941:ethics; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D028744:Ethics Committees, Research / Q000191:economics*; D005378:Financial Support; D006801:Humans; D054547:National Cancer Institute (U.S.); D009369:Neoplasms / Q000191:economics*; D012107:Research Design; D014481:United States