Clinical Trials Cut Drug Costs in Oncology Care Model

In this study, the researchers explored how participation in clinical trials affects drug costs and practice performance within the Oncology Care Model (OCM), a Medicare payment model aimed at reducing costs while enhancing cancer care. They aimed to determine whether clinical trials, despite their patient complexity and high costs, could offer cost benefits at academic cancer centers.

This research is significant because it challenges the belief that academic cancer centers are at a disadvantage in value-based care programs. Understanding the financial dynamics of clinical trials within the OCM can help improve healthcare cost management and encourage broader participation in such payment models. This has implications for healthcare providers, policy-makers, and patients by potentially reducing costs and improving care quality.

The researchers conducted a meta-analysis involving three National Cancer Institute-designated cancer centers: Yale, Sidney Kimmel, and O’Neal. They used patient data from July 2016 to January 2019, provided by the Centers for Medicare and Medicaid Services (CMS), to compare costs and performance between clinical trial episodes and nonclinical trial episodes. They calculated costs, including drug and other healthcare costs, and analyzed whether episodes met spending targets.

Clinical trial episodes had higher total costs than nonclinical trial episodes, averaging $42,225 compared to $34,937. However, drug costs were lower in clinical trial episodes, with a significant difference at the largest center. Clinical trial episodes were more likely to be under CMS spending targets, suggesting potential cost advantages. This indicates that the assumption of disadvantage for academic centers may be incorrect, as clinical trials could offer financial benefits.

The findings suggest that clinical trials may shift some drug costs from payors to trial sponsors, offering a cost-saving strategy for academic centers. This could encourage more participation in value-based care models by demonstrating that clinical trials might not be as financially burdensome as previously thought.

The authors recommend further research to explore the impact of clinical trials on healthcare costs, considering factors like disease stage and patient health status. They also suggest examining how value-based programs can better incorporate the complexities and costs of clinical research to enhance participation and optimize healthcare spending.