Financial

Hospital bottom lines: Why clinical trial enrollment is abysmal

12:27 pm by

To help reshape the severely flawed U.S. clinical trial system (see above), physicians need better incentives to enroll their patients, said Dr. Roxana Mehran, a cardiology professor hailing from Icahn School of Medicine. Here’s why:

Fifteen percent of clinical trial sites don’t enroll patients at all, Mehran said at this week’s AdvaMed conference in Chicago. On the flip side, 20 percent of clinical trial sites are responsible for enrolling 90 percent of the patients in device, drug and diagnostic studies. Something’s a touch askew, no?

The trial’s complexity dictates why some centers are more or less inclined to actively participate in clinical trials, Mehran said. It leans on how much time’s needed to recruit and screen patients – and many physicians and even ancillary coordinators find that the time involved just isn’t worth it.

“Coordinators find reasons to not enroll instead of to enroll, because it’s less work for them,” Mehran said. “It’s a very complex web.”

So why incentivize physicians? Because when it comes to hospitals, they’re all about the business. Mehran said docs are “under such guns” by hospitals to basically account for every minute they spend – and make sure those minutes are profitable. And many physicians are paid, she said, based on what revenues they bring to the hospital. So if they’re asked to do the laborious job of enrolling patients in a clinical trial, Mehran argued, they should be reimbursed accordingly for their time and effort.

But academic institutions and hospitals are often unwilling to pay those who conduct clinical trials, Mehran said, because at the end of the day, budget negotiations have become immensely complex.

“The way hospitals look at it is, ‘what’s in it for us? What do I get out of this?’” Mehran said. Hospitals want the tags of being centers of excellence, or attracting the high profile of being the center of choice for Bill Clinton or Barbara Walters, “but there is a bottom line issue that always comes up,” she said.

Mehran said she reports to a dean who has to take about 35 to 45 percent of the funds that come into the clinical research infrastructure for the work they’re doing – just for the overhead costs. The room rumbled with grouchy murmurs when Mehran said the following: With the NIH studies, institutions get about 75 percent of the funding for overhead, but only 35 percent from those who conduct clinical trials.

READ THE REST HERE

Josh Sandberg

Josh Sandberg is the President and CEO of Ortho Spine Partners and sits on several company and industry related Boards. He also is the Creator and Editor of OrthoSpineNews.

Related Articles

Back to top button