Are Clinical Trials a Cost-Effective Investment?

JAMA. 1989 Oct 6;262(13):1795-800.

Abstract

To assess the economic attractiveness of clinical research, this study measures the cost-effectiveness of seven selected randomized trials. The model considers the cost of performing a trial and the benefits to the health status of a target population one could expect before the trial was performed. The incremental cost-effectiveness for performing the trials ranged from a low of $2 to $3 per life-year saved for a trial of aspirin in unstable angina to a high of $396 to $685 per life-year saved for the randomized trial portion of the Coronary Artery Surgery Study. These ratios were substantially lower (ie, more economically attractive) than the cost-effectiveness ratios associated with performing interventions of proved effectiveness. This study shows that a selected group of clinical trials, some of which were controversial and expensive, were indeed a good investment. This information may be helpful to policymakers who consider allocating funds to biomedical research.

KIE: Detsky describes the use of cost-effectiveness analysis to assess the economic attractiveness of clinical research. A theoretical model to measure cost-effectiveness was applied to a selected group of seven clinical trials performed over the last two decades. The model was used to consider the cost of performing a trial and the expected benefits to the health status of a target population before a trial is performed. The results then were compared with the cost-effectiveness ratios associated with performing conventional interventions of proved effectiveness. Results showed that the trials were a good investment, with lower dollar per life-year saved ratios than those associated with the proven interventions. Detsky sees the study results as being useful to policy makers who must set priorities when allocating health care funds in a climate of scarcity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomedical Research*
  • Cardiovascular Diseases
  • Clinical Trials as Topic / economics*
  • Cost-Benefit Analysis
  • Health Services Research / economics*
  • Models, Statistical
  • Random Allocation
  • Resource Allocation*
  • United States