title: The business case for provider participation in clinical trials research: an application to the National Cancer Institute's community clinical oncology program.
abstract: BACKGROUND
  Provider-based research networks (PBRNs) make clinical trials available in community-based practice settings, where most people receive their care, but provider participation requires both financial and in-kind contributions.
  
  
  OBJECTIVE
  The aim of this study was to explore whether providers believe there is a business case for participating in PBRNs and what factors contribute to the business case.
  
  
  METHODS
  We use a multiple case study methodology approach to examine the National Cancer Institute's community clinical oncology program, a long-standing federally funded PBRN. Interviews with 41 key informants across five sites, selected on the basis of organizational maturity, were conducted using a semistructured interview guide. We analyzed interview transcripts using an iterative, deductive process to identify themes and subthemes in the data.
  
  
  RESULTS
  We found that a business case for provider participation in PBRNs may exist if both direct and indirect financial benefits are identified and included in the analysis and if the time horizon is long enough to allow those benefits to be realized. We identified specific direct and indirect financial benefits that were perceived as important contributors to the business case and the perceived length of time required for a positive return to accrue.
  
  
  CONCLUSIONS
  As the lack of a business case may result in provider reluctance to participate in PBRNs, knowledge of the benefits we identified may be crucial to encouraging and sustaining participation, thereby preserving patient access to innovative community-based treatments. The results are also relevant to federally funded PBRNs outside of oncology or to providers considering participation in any clinical trials research.
authors.affiliation: Paula H. Song, PhD, is Assistant Professor, Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus. E-mail: psong@cph.osu.edu. Kristin L. Reiter, PhD, is Associate Professor, Department of Health Policy and Management, The University of North Carolina at Chapel Hill. E-mail: reiter@email.unc.edu. Bryan J. Weiner, PhD, is Professor, Department of Health Policy and Management, The University of North Carolina at Chapel Hill. E-mail: weiner@email.unc.edu. Lori Minasian, MD, is Chief, Community Oncology and Prevention Trials Research Group, Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland. E-mail: minasilo@mail.nih.gov. Ann Scheck McAlearney, ScD, is Professor, Department of Family Medicine, College of Medicine, and Professor, Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus. E-mail: Ann.McAlearney@osumc.edu.
authors.forename: Paula H
authors.initials: PH
authors.lastname: Song
authors.forename: Kristin L
authors.initials: KL
authors.lastname: Reiter
authors.forename: Bryan J
authors.initials: BJ
authors.lastname: Weiner
authors.forename: Lori
authors.initials: L
authors.lastname: Minasian
authors.forename: Ann Scheck
authors.initials: AS
authors.lastname: McAlearney
mesh_terms: D002986:Clinical Trials as Topic; D003132:Commerce / Q000191:economics / Q000458:organization & administration; D003362:Cost-Benefit Analysis; D004345:Drug Industry / Q000191:economics / Q000458:organization & administration; D019981:Health Care Sector / Q000191:economics / Q000458:organization & administration; D006801:Humans; D007373:Interinstitutional Relations; D007407:Interviews as Topic; D008495:Medical Oncology / Q000458:organization & administration*; D054547:National Cancer Institute (U.S.) / Q000458:organization & administration; D014481:United States