Clinical Trial Costs Are Similar To and May be Less Than Standard Care and Inpatient (INPT) Charges at an Academic Medical Center (AMC) are Similar to Major, Minor and Non-Teaching Hospitals

James Metz, MD
OncoLink Associate Editor
Last Modified: May 20, 2000

Presenter: J. Quirk
Affiliation: Memorial Sloan-Kettering Cancer Center

Background:

Payers limit access to medical centers where clinical trials are performed. Insurance companies and Medicare have not facilitated treatment in clinical trials due to presumed huge costs.

Materials and Methods:

Retrospective review of 152 medicare eligible patients treated with chemotherapies.
77 patients on Phase II/III Trials (all from Memorial Sloan-Kettering Cancer Center)
75 matched patients treated with standard care (all from Memorial Sloan-Kettering Cancer Center)
All inpatient, outpatient presumed physical costs were included and adjusted to 1995 dollars.
Statewide database of inpatient charges between academic medical center, major teaching, minor teaching, non-teaching hospitals was analyzed.

Results:

Mean total costs were $30,775 US (clinical trials patients) and $37,055 (standard treatment).
Charges were 17% less for patients in clinical trials (p=0.08).
Average inpatient charges for academic medical center ($17,861) vs. major teaching hospital ($21,993) vs. minor teaching hospital ($16,594) vs. non-teaching hospital ($16,459) were not significantly different.

Authors' Conclusions

Costs of clinical trials are similar to costs of standard care.
Academic medical centers differ little in adjusted inpatient charges compared to other centers.
This suggest clinical trials and academic medical centers are a good investment.
Reimbursement will not bankrupt payers or increase consumer premiums.

Clinical/Scientific Implications:

This study gives further evidence that clinical trials do not cost more than standard medical care. Some of the reduced cost may be because chemotherapy drugs are often provided free of charge on clinical trials. More studies such as this are needed to convince third party payers that clinical trials are a good investment.

ASCO Abstract 1696