Effect of a US National Institutes of Health programme of clinical trials on public health and costs

@article{Johnston2006EffectOA,
  title={Effect of a US National Institutes of Health programme of clinical trials on public health and costs},
  author={S. Johnston and J. Rootenberg and S. Katrak and Wade S. Smith and J. Elkins},
  journal={The Lancet},
  year={2006},
  volume={367},
  pages={1319-1327}
}
BACKGROUND Few attempts have been made to estimate the public return on investment in medical research. The total costs and benefits to society of a clinical trial, the final step in testing an intervention, can be estimated by evaluating the effect of trial results on medical care and health. METHODS All phase III randomised trials funded by the US National Institute of Neurological Disorders and Stroke before Jan 1, 2000, were included. Pertinent publications on use, cost to society, and… Expand
Translating Research Findings Into Practice—The Unfulfilled and Unclear Mission of Observational Data
Randomized clinical trials (RCTs) are rightfully valued as the primary source of research data that drives changes in practice and directs evidence-based care. However, the time and associated costsExpand
The value proposition of investigator‐initiated clinical trials conducted by networks
  • Medicine
  • The Medical journal of Australia
  • 2021
TLDR
This study finds that while the proportion of funding for nonindustry-sponsored investigator-initiated clinical trials (IITs) is relatively small, these studies account for more than half of Australia’s clinical trial activity. Expand
Conducting clinical trials—costs, impacts, and the value of clinical trials networks: A scoping review
TLDR
Key findings from the review are: 1) delayed trial activation has costs to budgets and research; 2) poor accrual leads to low-value trials and wasted resources; 3) the pharmaceutical industry can be a pragmatic, if problematic, partner in clinical research; and there are spillover benefits of clinical trials to healthcare systems. Expand
Lessons Learned and Future Directions
Since 1977 the National Institute of Neurological Disorders and Stroke (NINDS) at the National Institutes of Health (NIH) has sponsored 28 phase 3 trials to evaluate treatments of stroke, which whenExpand
Publicly funded practice-oriented clinical trials: of importance for healthcare payers.
TLDR
Government should see public funding of pragmatic practice-oriented clinical trials as a good opportunity to improve the selection and quality of treatments and stimulate efficient use of limited resources. Expand
Closing the cycle of innovation in healthcare in Europe
TLDR
It would appear reasonable that decision makers should get more involved in priority setting and funding also in the field of clinical research in order to provide further evidence needed for assessments, reassessments, and subsequent qualified decisions and resource allocations in health care. Expand
NINDS clinical trials in stroke: lessons learned and future directions.
Since 1977 the National Institute of Neurological Disorders and Stroke (NINDS) at the National Institutes of Health (NIH) has sponsored 28 phase 3 trials to evaluate treatments of stroke, which whenExpand
The Economic Case for New Stroke
Background—The societal costs and health benefits of tissue plasminogen activator (tPA) for ischemic stroke can be modeled and extended to the US population. Similarly, the societal impact of newExpand
NIH Disease Funding Levels and Burden of Disease
TLDR
Current levels of NIH disease-specific research funding correlate modestly with US disease burden, and correlation has not improved in the last decade. Expand
Does health intervention research have real world policy and practice impacts: testing a new impact assessment tool
TLDR
A modified impact assessment process that builds on best practice to 5 years of intervention research funded by Australia's National Health and Medical Research Council to determine if these studies had post-research real-world policy and practice impacts was applied. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 64 REFERENCES
Can Medical Cost-Effectiveness Analysis Identify the Value of Research?
Substantial investments in biomedical research over the past 50 years have generated new technologies that have significantly decreased mortality and morbidity. While there appears to be broadExpand
Quality of systematic reviews of economic evaluations in health care.
TLDR
The reviews found consistent evidence of serious methodological flaws in a significant number of economic evaluations, and editorial teams and regulatory bodies should perform quality assurance based on a single widely accepted and validated standard instrument. Expand
Estimating the economic value to societies of the impact of health research: a critical review.
TLDR
The review did not identify any consistency of methodology, but the fourth approach has most promise as a measure of social value. Expand
Measuring the Gains from Medical Research: An Economic Approach
In 1998, health expenditures in the United States accounted for 12.9% of national income - the highest share of income devoted to health in the developed world. The United States also spends more onExpand
Payback arising from research funding: evaluation of the Arthritis Research Campaign.
TLDR
A structured evaluation framework was applied to 16 case studies of research grants funded by the Arthritis Research Campaign in the early 1990s and a range of research paybacks was identified. Expand
Relation between prepublication release of clinical trial results and the practice of carotid endarterectomy.
TLDR
Pre prepublication dissemination of CEA trial results with clinical alerts was associated with prompt and substantial changes in medical practice, but the observed changes suggest that the results were extrapolated to patients and settings not directly supported by the trials. Expand
Making economic evaluations respectable.
TLDR
It is proposed in this paper that this particular barrier to the use of economic evaluations in health policy could be overcome if these analyses were more routinely subjected to the rigorous and penetrating audits that are customary in financial accounting. Expand
Cost-effectiveness of carotid endarterectomy in asymptomatic patients.
TLDR
Sensitivity analysis demonstrated that the relative cost of surgical treatment increased substantially with increasing age, increasing perioperative stroke rate, and decreasing stroke rate during medical management, indicating that carotid endarterectomy is cost-effective when compared with other commonly accepted health care practices. Expand
The underutilization of cardiac medications of proven benefit, 1990 to 2002.
TLDR
Although use is increasing, it remains lower than expected, and some increases noted in earlier years have slowed, suggesting substantial public health benefits would result from further adoption of these effective therapies. Expand
Multistate utilization, processes, and outcomes of carotid endarterectomy.
TLDR
All surgeons performing CEA should participate in outcome assessment and adopt protocols that include the routine administration of antiplatelet agents preoperative, the use of heparin intraoperatively, and patch angioplasty of the endarterectomy site. Expand
...
1
2
3
4
5
...