Free-riding and the prisoner's dilemma: problems in funding economic analyses of phase III cancer clinical trials

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
C L BennettH B Niell

Abstract

Both economic and clinical data on new agents are important to policy-makers who approve pharmaceuticals for widespread use. Randomized clinical trials have been used to evaluate both clinical results and total medical costs associated with new agents. With new expensive pharmaceutical agents, early assessments of economic benefit have taken on greater importance to physicians and patients. Who should provide financial support to these integrated economic and clinical analyses in clinical trials? Here we describe issues that hinder funding of economic analyses and propose potential support mechanisms. The Cancer and Leukemia Group B (CALGB), a large, national cooperative group of academic and community hospitals in the United States, designed a non-small-cell lung cancer (NSCLC) treatment trial to compare two widely used supportive care regimens that varied 20-fold in cost. One important objective of this trial was to compare the cost-effectiveness of the two regimens. While funding for the clinical trial was supported by grants from the National Cancer Institute and the pharmaceutical companies involved in the trial, no specific funding agency was willing and/or able to provide financial support for the economic analyses. Afte...Continue Reading

Citations

Jan 1, 1997·Cancer Investigation·C L Bennett, T M Waters
Feb 25, 2003·Cancer Control : Journal of the Moffitt Cancer Center·Thomas N Chirikos
Mar 22, 2013·The New England Journal of Medicine·Charles L BennettJames O Armitage
Jan 10, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Johanna N H Timmer-BonteVivianne C G Tjan-Heijnen
Feb 21, 2002·Journal of the National Cancer Institute·Scott D RamseyDavid R Gandara
Nov 1, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Johanna N Timmer-BonteVivianne C Tjan-Heijnen

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