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AUSTRALIA’S top health bureaucrat has challenged medical researchers to identify potential cost-savings in the health budget that would enable additional funding of investigator-initiated clinical trials.
Adjunct Professor Jane Halton, secretary of the Department of Health and Ageing, told last week’s MJA Clinical Trials Research Summit in Sydney that the current economic climate meant it was impossible to dedicate additional money to these trials without cutting other areas of spending.
However, in a speech on behalf of the Minister for Health, Tanya Plibersek, Professor Halton said the Gillard government valued the contribution made by investigator-initiated trials. She noted that such trials were driven not by a desire to increase profits, but to improve efficiency, transparency and the evidence base.
“The questions they ask would not be pursued if commercial interests were the only motivator”, she said.
“The government is extremely interested in the ideas generated at today’s summit to provide greater support to investigator-led clinical trials.”
Professor Steve Webb, senior staff specialist in intensive care at Royal Perth Hospital, welcomed Professor Halton’s comments, saying it was now up to clinical researchers to move away from simplistic demands for additional funding.
“The ball’s in our court. If we have a compelling case, we can make it happen. We should take advantage of that opportunity”, he said.
The summit was told of several examples of research conducted by clinical trials groups that had generated millions of dollars of savings for the health budget.
Professor Webb described a study which found that decompressive craniectomy for traumatic brain injury was linked to an increased risk of poor neurological outcomes, despite the fact that this procedure was part of standard care for these patients. (1)
Although the trial was not driven by commercial or industry interests, curtailing this procedure in Australian hospitals had generated savings of at least $100 million a year, Professor Webb said.
Professor Halton acknowledged the potential dividends of such research, but said the problem was generating the initial funding to provide greater support for clinical trials groups.
A common theme at the summit was the need for a continuous funding stream rather than project-dependent funding. Many presenters said that clinical researchers essentially donated their time to conduct such trials.
Several suggestions were put to the summit for innovative funding models. Professor Webb suggested a “commission-based” system, where research networks that generated substantial cost-savings for the health system would receive a proportion of those savings to support their work.
Professor Anthony Keech, deputy director of the NHMRC Clinical Trials Centre, suggested an “aspirational” funding commitment from the government, similar to that which exists for foreign aid.
Many speakers, including keynote speaker Professor Paul Glasziou, professor of evidence-based medicine at Bond University, praised the UK’s National Institute of Health Research model, which had dramatically increased the amount of applied research in that country.
Professor Warwick Anderson, chief executive officer of the NHMRC, said his organisation would be seeking consultation on several new approaches to support clinical trials research in the second half of 2012.
One proposal would allow researchers to apply for NHMRC grants at any time of the year, rather than the current once-a-year approach.
Dr Annette Katelaris, editor of the MJA, said the summit was driven by the need to secure additional funding and support for trials in a clinical and patient-centred setting.
– Sophie McNamara
1. N Engl J Med 2011; 364:1493-1502
Posted 21 May 2012
1.The concept is a promising one.
2. Although I have never been in contact with the Head of Health and Aging, I have been delighted and reassured that her courage shown during the Tampa crisis has not, apparently, harmed her career in the A.G.S.!