Investigator‐initiated trials run by clinical trial networks provide net economic benefits to health systems
Delivery of optimal health care relies on evidence from randomised clinical trials, among other factors, to inform best practice. While the generation of such evidence requires resources, both national and international assessments of health and economic benefits resulting from medical research indicate large returns on investment.1,2,3 In Australia, during the decade 2006–2015, more than 10 000 clinical trials were conducted through Australian clinical trials networks (CTNs), including more than 5 million participants, ranking Australia in the top tier of clinical trial activity.4 Industry‐funded clinical trials accounted for an estimated $930 million of the total $1.1 billion spent annually on clinical trials, with National Health and Medical Research Council (NHMRC) funding accounting for about $164 million annually.4 While the proportion of funding for non‐industry‐sponsored investigator‐initiated clinical trials (IITs) is relatively small, these studies account for more than half of Australia’s clinical trial activity.4 This study funding balance is similar to what is reported elsewhere.5
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The joint ACTA/ACSQHC Working Group (article authors): Rhiannon Tate (Monash University, VIC), Emma Britton (Australian Commission on Safety and Quality in Healthcare [ACSQHC], NSW), Steve Webb (Monash University, VIC), Charlotte Ramage (Quantium Health, VIC), Julie Bernhardt (Florey Institute of Neuroscience and Mental Health, VIC), Alan Cass (Menzies School of Health Research, NT), Craig J French (Western Health, VIC), Katie Groom (University of Auckland, New Zealand), Robert Herkes (ACSQHC, NSW), Catherine Katz (ACSQHC, NSW), Ben W Mol (University of Adelaide, SA), R John Simes (NHMRC Clinical Trials Centre, NSW), Neil Sonderlund (Quantium Health, VIC), Belinda E Butcher (WriteSource Medical and UNSW Sydney, NSW), and John R Zalcberg (Monash University, VIC). The Australian Clinical Trials Alliance (ACTA) acknowledges operational funding from the Australian Government’s Medical Research Future Fund. Ben Mol reports an investigator grant (GNT1176437) from the National Health and Medical Research Council (NHMRC).
Charlotte Ramage reports consulting fees from Australian Clinical Trials Alliance during the conduct of the study. Julie Bernhardt reports personal fees from Dart Neuroscience, outside the submitted work. Ben Mol reports personal fees from Guerbet; he has received research funding from Guerbet and Merck, has been a member of the ObsEva advisory board and holds stock options for ObsEva, outside the submitted work. Neil Soderlund reports consultancy fees from Australian Commission on Safety and Quality in Health Care during the conduct of the study. John Zalcberg reports investments in GW Pharmaceuticals, Aimmune, Vertex, Alnylam, BioMarin, Gilead, Moderna, Concert Pharmaceuticals, Madrigal Pharmaceuticals, MyoKardia, Orphazyme, CRISPR, Myovant, Frequency Therapeutics, Global Blood Therapeutics, uniQure, Sangamo Biosciences, Acceleron, Zogenix; grants and personal fees from Pfizer; grants, personal fees and non‐financial support from Merck Serono; grants and personal fees from Specialized Therapeutics; personal fees from Targovax, Halozyme, Gilead Sciences, Sirtex Medical, and Lipotek; personal fees and non‐financial support from MSD; grants from Bayer, Roche, BMS, Baxalta/Shire, Lilly, and Boehringer‐Ingelheim; grants and non‐financial support from AstraZeneca; non‐financial support from Deciphera, outside the submitted work. He is Chair at Australian Clinical Trials Alliance, and Co‐Chair at National Oncology Alliance and at All.Can Australia.