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Estimation of drug cost avoidance and pathology cost avoidance through participation in NCIC Clinical Trials Group
P A Tang1, A E Hay2, C J O'Callaghan2
1Tom Baker Cancer Centre, University of Calgary, Calgary, AB;
Background:
Cost avoidance occurs when, because of provision of a drug therapy [drug cost avoidance (dca)] or a pathology test [pathology cost avoidance (pca)] during trial participation, health care payers need not pay for standard treatments or testing. The aim of our study was to estimate the total dca and pca for Canadian patients enrolled in relevant phase iii trials conducted by the ncic Clinical Trials Group.
Methods:
Phase iii trials that had completed accrual and resulted in dca or pca were identified. The pca was calculated based on the number of patients screened and the test cost. The dca was estimated based on patients randomized, the protocol dosing regimen, drug cost, median dose intensity, and median duration of therapy. Costs are presented in Canadian dollars. No adjustment was made for inflation.
Results:
From 1999 to 2011, 4 trials (1479 patients) resulted in pca and 17 trials (3195 patients) resulted in dca. The total pca was estimated at $4,194,849, which included testing for KRAS ($141,058), microsatellite instability ($18,600), and 21-gene recurrence score ($4,035,191). The total dca was estimated at $27,952,512, of which targeted therapy constituted 43% (five trials). The combined pca and dca was $32,147,361.
Conclusions:
Over the study period, trials conducted by the ncic Clinical Trials Group resulted in total cost avoidance (pca and dca) of approximately $7,518 per patient. Although not all trials lead to cost avoidance, such savings should be taken account when the financial impact of conducting clinical research is being considered.
Insights
Clinical trials for cancer patients in Canada generated significant cost savings. Drug therapy and pathology test costs avoided totaled over $32 million, demonstrating value in research participation.
Area of Science:
- Oncology
- Health Economics
- Clinical Research
Background:
- Cost avoidance in clinical trials occurs when drug therapies or pathology tests provided during participation reduce healthcare payer expenses for standard treatments.
- The study focuses on estimating drug cost avoidance (dca) and pathology cost avoidance (pca) for Canadian patients in phase iii trials.
Purpose of the Study:
- To quantify the total drug cost avoidance (dca) and pathology cost avoidance (pca) for Canadian patients participating in relevant phase iii trials.
- To assess the financial impact and cost-effectiveness of conducting clinical research.
Main Methods:
- Identified phase iii trials with completed accrual that resulted in dca or pca.
- Calculated pca based on patient screening numbers and test costs.
- Estimated dca using randomized patients, protocol dosing, drug costs, dose intensity, and therapy duration.
Main Results:
- From 1999 to 2011, 4 trials yielded pca ($4,194,849) and 17 trials yielded dca ($27,952,512).
- Key pca components included KRAS, microsatellite instability, and 21-gene recurrence score testing.
- Targeted therapy accounted for 43% of the total dca.
- Combined pca and dca reached $32,147,361.
Conclusions:
- NCIC Clinical Trials Group trials resulted in approximately $7,518 cost avoidance per patient.
- Clinical research participation offers significant financial benefits through cost avoidance.
- These savings should be considered when evaluating the overall financial impact of clinical research.
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