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Do randomized controlled trials discuss healthcare costs?
G Michael Allan1, Christina Korownyk, Kate LaSalle
1Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada. michael.allan@ualberta.ca
Plos One
|September 3, 2010
Summary
Randomized controlled trials (RCTs) rarely include cost information, with only 5% detailing actual drug costs. Industry-funded studies were significantly less likely to report any cost data, impacting healthcare economic evaluations.
Area of Science:
- Health Economics
- Clinical Trial Methodology
- Pharmaceutical Policy
Background:
- Healthcare expenditures, especially pharmaceutical costs, are a significant concern for organizations.
- The routine inclusion of cost data in randomized controlled trials (RCTs) is not well-established.
Purpose of the Study:
- To determine the frequency of cost inclusion in RCTs.
- To identify factors associated with the reporting of cost information in clinical trials.
Main Methods:
- A random sample of 188 RCTs published between 2003-2005 from six high-impact journals was analyzed.
- Two independent reviewers extracted cost data and study characteristics.
- Statistical analyses, including logistic regression, were used to explore factors associated with cost inclusion.
Main Results:
- Actual drug costs were reported in only 4.7% of RCTs, and any cost mention appeared in 27.7%.
- Increased industry funding correlated with a statistically significant reduction in reporting any actual costs (p=0.005) and any cost mention (p=0.02).
- Funding source was significantly associated with the inclusion of cost information (OR=0.34 for actual costs, OR=0.63 for any mention).
Conclusions:
- Actual drug cost information is infrequently reported in RCTs, with 72% omitting any mention.
- Industry-funded trials demonstrate a lower likelihood of including cost data.
- No other study characteristics, such as journal impact, conclusions, or location, were associated with cost reporting.
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