Attribution of costs associated with cancer trials conducted at a single UK institution


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Session type:

Pippa Corrie1,2, Jamie Weaver1, Anita Chhabra1, Vicky Kingshott1, Karen Hayton3, Sue Bailey1, Liz Andersen1, Ingrid Inman1, Roy Harris1, George Follows1, Mike Harrison1, Tim Eisen1,2
1Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK, 2University of Cambridge, Cambridge, UK, 3NHS Cambridgeshire, Cambridge, UK

Background

Since 2001, the proportion of cancer patients entering trials in the UK has risen from 3.5% of incident cases to 18.1% in 2009. Cancer drug trials are widely perceived to generate excess, undeclared costs to the NHS. Working with our local commissioners, we aimed to determine whether these claims could be substantiated

Method

Addenbrooke’s is an acute general hospital which hosts one of the highest recruiting UK regional cancer research networks (37.2% patients entering trials in 2009/10). The case report forms of all Addenbrooke’s patients entered into cancer trials involving IMPs between 1 January and 31 December 2009 were reviewed. For each recruited patient, the cancer drug(s), exact dose(s) and number of cycles delivered were determined and (for licensed agents) costed, inclusive of VAT. Patients recruited to 1 academic (Telovac) and 1 commercial (Comparz) NIHR portfolio trial that year were tracked to assess any impact on commissioners

Results

204 adult patients were entered into 43 trials (32 phase III, 9 phase II, 2 phase I). 31 trials were in the NIHR portfolio (23 academic, 8 commercially sponsored), 12 were commercial, non-portfolio trials. Patients received IMPs which were either unlicensed (13), licensed (2), or licensed drugs in an unlicensed indication (34). When compared with standard of care (SOC), drug cost savings were identified in 19 trials and excess treatment cost in 1 trial. The total value of drug provided free of charge was £517K, the excess treatment cost was £119. Compared to SOC, there was an overall drug cost saving of £242K. Savings were mainly attributable to pharmaceutical company support and trials addressing treatment duration. Detailed analysis of patients recruited to Telovac (8) and Comparz (11) identified that the PCT had been charged £7,980 research costs

Conclusion

Cancer trials save drug costs; research costs risk being passed on to commissioners