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Gómez Mediavilla B, Lanza León P, Martínez Callejo V, Cantarero Prieto D, Lanza Postigo M, Salcedo Lambea M, Blanco Mesonero Y, Ochagavia Sufrategui M, Durán I, Sarabia Cobo CM. Pharmaceutical cost savings from the treatment of oncology patients in clinical trials. Biomed J 2024:100742. [PMID: 38679197 DOI: 10.1016/j.bj.2024.100742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/22/2024] [Accepted: 04/24/2024] [Indexed: 05/01/2024] Open
Abstract
OBJECTIVE The aim of this study was twofold: to assess the annual pharmaceutical savings associated with the treatment of cancer patients at Marqués de Valdecilla University Hospital and to estimate the cost of innovative antineoplastic therapies that patients receive as experimental treatment, both during clinical trials throughout 2020. MATERIAL AND METHODS An observational and financial analysis of the drug cost related to clinical trials was applied. Direct cost savings to the Regional Health System of Cantabria and the cost of innovative therapies used as an experimental treatment in clinical trials were quantified. RESULTS This study includes 38 clinical trials with a sample of 101 patients. The clinical trials analyzed provide a total cost savings of €603,350.21 and an average cost saving of €6,630.22 per patient. Furthermore, the total investment amounts to €789,892.67, with an average investment of €15,488.09 per patient. CONCLUSIONS Clinical trials are essential for the advancement of science. Furthermore, clinical trials can be a significant source of income for both hospitals and Regional Health Systems, contributing to their financial sustainability.
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Affiliation(s)
- Borja Gómez Mediavilla
- Medical Oncology and Nanovaccines Research Gruop, Instituto de Investigación Valdecilla-IDIVAL, Santander, Spain
| | - Paloma Lanza León
- Departamento de Economía, Universidad de Cantabria, Santander, Spain; Health Economics Research Group, Valdecilla Biomedical Institute Research - IDIVAL, Santander, Spain.
| | | | - David Cantarero Prieto
- Departamento de Economía, Universidad de Cantabria, Santander, Spain; Health Economics Research Group, Valdecilla Biomedical Institute Research - IDIVAL, Santander, Spain
| | - María Lanza Postigo
- Medical Oncology and Nanovaccines Research Gruop, Instituto de Investigación Valdecilla-IDIVAL, Santander, Spain
| | - Matilde Salcedo Lambea
- Medical Oncology and Nanovaccines Research Gruop, Instituto de Investigación Valdecilla-IDIVAL, Santander, Spain
| | - Yolanda Blanco Mesonero
- Medical Oncology and Nanovaccines Research Gruop, Instituto de Investigación Valdecilla-IDIVAL, Santander, Spain
| | | | - Ignacio Durán
- Medical Oncology and Nanovaccines Research Gruop, Instituto de Investigación Valdecilla-IDIVAL, Santander, Spain; Department of Medical Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Carmen María Sarabia Cobo
- Department of Nursing, Universisty of Cantabria, Santander, Spain; Instituto de Investigación Valdecilla-IDIVAL, Santander, Spain
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Perrier Q, Minoves M, Cerana S, Reymond F, Ducki C, Decaens T, Lehmann A, Bedouch P. Evaluation of drug cost savings related to clinical trials from the perspective of a university hospital. Eur J Hosp Pharm 2023:ejhpharm-2022-003671. [PMID: 37248032 DOI: 10.1136/ejhpharm-2022-003671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 05/10/2023] [Indexed: 05/31/2023] Open
Abstract
OBJECTIVES Clinical trials are an opportunity for patients to access innovative therapy, but patient inclusion in clinical trials can also result in cost savings for hospitals. Our objective was to evaluate the economic impact of clinical trials drug cost savings in a French academic institution from the perspectives of both the French Health Insurance (FHI) and hospitals. METHODS A retrospective, observational, cost saving analysis was performed on all the clinical trials initiated in our university hospital between 2015 and 2020. Only trials involving an investigational medicinal product were considered. Drug cost savings were defined as the best standard of care, defined in the protocol, whose cost was covered by a sponsor. RESULTS Of the 646 trials undertaken during the 6 years analysed, 21% (212/646) led to cost savings, mostly driven by the industrial sponsor (92%, €6 984 283/€7 591 612) for a total of €7 591 612 (91% from the FHI's perspective (€6 959 115/€7 591 612)). Oncology trials generated 79.1% (€6 004 966/€7 591 612) of global cost savings, mostly driven by onco-haematology (33.1%, €1 983 146/€6 004 966), onco-pneumology (29.2%, €1 754 333/€6 004 966) and onco-dermatology (23.5%, €1 409 553/€6 004 966) followed by hepatogastroenterology trials (6.9%, €413 113/€6 004 966). Of the 162 drugs, the top 15 generated 75.3% (€5 715 479/€7 591 612) of savings and were grouped together: 12 antineoplastic agents (six per os and six intravenous) and three per os antiviral for hepatitis C. CONCLUSIONS With ever-changing prices and new innovative treatments, such cost avoidance must be regularly evaluated. We provided objective evidence that clinical trials could achieve potential cost savings for the FHI and hospitals, in addition to the potential benefit to patients of having access to innovative investigational medicinal products.
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Affiliation(s)
- Quentin Perrier
- Univ. Grenoble Alpes, LBFA, INSERM, U1055, Pôle Pharmacie, Grenoble Alpes University Hospital, Grenoble, France
| | - Mélanie Minoves
- Univ. Grenoble Alpes, Hp2, INSERM, U1300, Pôle Pharmacie, Grenoble Alpes University Hospital, Grenoble, France
| | - Sophie Cerana
- Grenoble Alpes University, Grenoble Alpes University Hospital, Pôle Pharmacie, Grenoble, France
| | - Fabienne Reymond
- Grenoble Alpes University, Grenoble Alpes University Hospital, Pôle Pharmacie, Grenoble, France
| | - Camille Ducki
- Univ. Grenoble Alpes, IAB-INSERM U1209/ CNRS UMR 5309, Clinique Universitaire d'Hépato-gastroentérologie, Grenoble Alpes University Hospital, Grenoble, France
| | - Thomas Decaens
- Univ. Grenoble Alpes, IAB-INSERM U1209/ CNRS UMR 5309, Clinique Universitaire d'Hépato-gastroentérologie, Grenoble Alpes University Hospital, Grenoble, France
| | - Audrey Lehmann
- Univ. Grenoble Alpes, TIMC, CNRS, UMR5525, Pôle Pharmacie, Grenoble Alpes University Hospital, Grenoble, France
| | - Pierrick Bedouch
- Univ. Grenoble Alpes, TIMC, CNRS, UMR5525, Pôle Pharmacie, Grenoble Alpes University Hospital, Grenoble, France
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Sánchez Martínez DA, Salas-Lucia F, Jiang H, Ruiz-Carreño P, Alonso Romero JL. Drug cost avoidance analysis of cancer clinical trials in Spain: a study on cost contributors and their impact. BMC Health Serv Res 2022; 22:948. [PMID: 35883128 PMCID: PMC9316356 DOI: 10.1186/s12913-022-08222-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 06/13/2022] [Indexed: 11/10/2022] Open
Abstract
Objective Analyze the cost contributors and their impact on the drug cost avoidance (DCA) resulting from cancer clinical trials over the period of 2015–2020 in a tertiary-level hospital in Spain (HCUVA). Methods We performed a cross-sectional, observational, retrospective study of a total of 53 clinical trials with 363 patients enrolled. We calculated the DCA from the price of the best standard of care (i.e.: drugs that the institution would otherwise fund). A linear regression model was used to determine cost contributors and estimate their impact. Results The total DCA was ~ 4.9 million euros (31 clinical trials; 177 enrollees), representing ~ 30% and ~ 0,05% approximately of the annual pharmaceutical expenditures at the HCUVA and for the Spanish Health System, respectively. Cancer type analysis showed that lung cancer had the highest average DCA by trial, indicating that treatments in these trials were the most expensive. Linear regression analysis showed that the number of patients in a trial did not significantly affect that trial's DCA. Instead, cancer type, phase trials, and intention of treatment were significant cost contributors to DCA. Compared to digestive cancer trials, breast and lung trials were significantly more expensive, (p < 0.05 and p < 0.1, respectively). Phase III trials were more expensive than Phase II (p < 0.01) and adjuvant trials were less expensive than palliative (p < 0.05). Conclusion We studied cost contributors that significantly impacted the estimated DCA from cancer clinical trials. Our work provides the groundwork to explore DCA contributors with potential to enhance public relations material and serve as a negotiating tool for budgeting, thus playing an important role to inform decisions about resource allocation. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08222-9.
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Affiliation(s)
| | | | | | - Paula Ruiz-Carreño
- IMIB-Arrixaca. Medical Oncology Service, Hospital Clínico Universitario Virgen de La Arrixaca, Murcia, Spain
| | - José Luis Alonso Romero
- IMIB-Arrixaca. Medical Oncology Service, Hospital Clínico Universitario Virgen de La Arrixaca, Murcia, Spain
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Jommi C, Pantellini F, Stagi L, Verykiou M, Cavazza M. The economic impact of compassionate use of medicines. BMC Health Serv Res 2021; 21:1303. [PMID: 34863155 PMCID: PMC8645125 DOI: 10.1186/s12913-021-07255-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Compassionate use programs (CUP) for medicines respond to the ethical imperative of providing access to medicines before marketing approval to patients not recruited in trials. The economic impact of clinical trials has previously been investigated. No evidence on the net economic benefit of CUP exists. This research aims to address this information gap by estimating the economic consequences of 11 CUP in Italy conducted between March 2015 and December 2020 from the perspective of public health care system in Italy (National Health Service). Eight programs concern cancer treatments, two refer to spinal muscular atrophy, and one is indicated for multiple sclerosis. METHODS Since CUP medicines are covered by the industry, the net economic benefit includes: (i) avoided costs of the Standard of Care (SoC) the patients would have received had they not joined the CUP, (ii) costs not covered by the pharmaceutical industry sponsor, but instead sustained by payers, such as those associated with adverse events (only severe side effects resulting in hospitalisation and attributable to CUP medicines), and (iii) costs for combination therapies and diagnostic procedures not used with the SoC. The SoC costing relied on publicly available data. Information on adverse events and diagnostic procedures was retrieved from the CUP and monetized using the relevant fee for episode or service. One CUP was excluded since a SoC was not identified. RESULTS 2,713 patients were treated in the 11 CUP where a SoC was identified. The SoC mean cost per patient ranged from €11,415 to €20,299. The total cost of the SoC ranged between €31.0 and €55.1 million. The mean cost per patient covered by hospitals hosting CUP was equal to €1,646, with a total cost of €4.5 million. The net economic benefit ranged €26.5 million - €50.6 million. CONCLUSIONS Despite research limitations, this paper illustrates for the first time the net economic impact of CUP from a public payer perspective. It is important to integrate these estimates with the prospective effects of CUP implementation, i.e., the economic value of the comparative benefit profile of medicines used in CUP versus the SoC, including effects from a societal perspective.
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Affiliation(s)
- Claudio Jommi
- Centre for Research on Health and Social Care Management, SDA Bocconi School of Management, CERGAS, Bocconi University, Via Sarfatti 25, 20136 Milano, MI Italy
| | | | - Lisa Stagi
- ROCHE Spa, Viale GB Stucchi 110, MB 20900 Monza, Italy
| | - Maria Verykiou
- Centre for Research on Health and Social Care Management, SDA Bocconi School of Management, CERGAS, Bocconi University, Via Sarfatti 25, 20136 Milano, MI Italy
| | - Marianna Cavazza
- Centre for Research on Health and Social Care Management, SDA Bocconi School of Management, CERGAS, Bocconi University, Via Sarfatti 25, 20136 Milano, MI Italy
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