Objectives: Randomized clinical trials (RCTs) are costly and published information on resource requirements for their conduct is limited. To identify key factors for making RCTs more sustainable, empirical data on resource use and associated costs are needed. We aimed to retrospectively assess resource use and detailed costs of two academic, investigator-initiated RCTs using a comprehensive list of cost items.
Study Design And Setting: The resource use of two investigator-initiated RCTs (Prednisone-Trial [NCT00973154] and Oxantel-Trial [ISRCTN54577342]) was empirically assessed in a standardized manner through semistructured interviews and a systematically developed cost item list. Using information about yearly salaries, resource use was translated into costs. In addition, we collected all "other costs" including fixed priced items. Overall costs as well as cost of different study phases were calculated.
Results: The personnel time used in the Prednisone-Trial trial was approximately 2,897 working days and the overall costs were calculated to be USD 2.3 million, which was USD 700,000 more than planned. In the Oxantel-Trial 798 working days were spent and the overall costs were as originally planned USD 100,000. Cost drivers were similar between the two RCTs with recruitment delays explaining the additional costs in the Prednisone-Trial.
Conclusion: This case study provides an example of how to transparently assess resources and costs of RCTs and presents detailed empirical data on type and magnitude of expenses. In the future, this model approach may serve others to plan, assess, or monitor resource use and costs of RCTs.
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http://dx.doi.org/10.1016/j.jclinepi.2017.12.022 | DOI Listing |
JMIR Infodemiology
January 2025
Salzburg University of Applied Sciences, Puch/Salzburg, Austria.
Background: The novel coronavirus disease (COVID-19) sparked significant health concerns worldwide, prompting policy makers and health care experts to implement nonpharmaceutical public health interventions, such as stay-at-home orders and mask mandates, to slow the spread of the virus. While these interventions proved essential in controlling transmission, they also caused substantial economic and societal costs and should therefore be used strategically, particularly when disease activity is on the rise. In this context, geosocial media posts (posts with an explicit georeference) have been shown to provide a promising tool for anticipating moments of potential health care crises.
View Article and Find Full Text PDFNeurology
February 2025
From the Temple University College of Public Health (I.L.H.); Thomas Jefferson University (G.G.); and Department of Neurology (T.D.H.-P.), Lewis Katz School of Medicine at Temple University, Philadelphia, PA.
Background And Objectives: Clinical care for people living with amyotrophic lateral sclerosis (PLWALS) is directed at slowing disease progression and symptom management. The American Academy of Neurology recommends a multidisciplinary approach to providing ALS health care because observational studies show that multidisciplinary clinics (MDCs) extend survival and improve quality of life. However, providing multidisciplinary care is a challenging financial proposition.
View Article and Find Full Text PDFJCO Glob Oncol
January 2025
Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada.
Purpose: Asparaginase (ASN) is a critical component of pediatric ALL protocols. Until recently, ASN was available in three formulations: native Escherichia coli, PEGylated E. coli (PEG), and Erwinase, with native E.
View Article and Find Full Text PDFAnnu Rev Genomics Hum Genet
January 2025
1Department of Medical Genetics and Genomic Medicine, School of Medical Sciences, University of Campinas, Campinas, Brazil;
Integrating genomics into healthcare within the precision medicine (PM) framework poses distinct challenges in resource-limited regions like Latin America and the Caribbean (LAC). These challenges arise partly from the lack of PM models tailored for low- and middle-income countries. To address this, healthcare authorities in LAC should adopt predictive models to estimate costs and infrastructure needed for PM programs.
View Article and Find Full Text PDFPLoS One
January 2025
Division of Hepatobiliary and Transplantation Surgery, Department of Surgery, Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Background And Objectives: Urological complications after kidney transplantation, due to the ureteroneocystostomy, are associated with significant morbidity, prolonged hospital stay and even mortality. Ureteral stents can minimize the number of complications but are not consistently used, as previous studies were retrospective in nature. We aim to prospectively determine the most effective stenting approach.
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