The association between clinical trial participation, drug costs, and performance in the Oncology Care Model (OCM)
Menée aux Etats-Unis, cette étude examine l'association entre la participation à des essais cliniques, le coût des anticancéreux et la performance des pratiques en cancérologie dans le cadre de l'"Oncology Care Model", un modèle de paiement (alternatif au système Medicare) dont l'objectif visait à réduire les coûts tout en améliorant les soins
It has long been assumed that academic oncology practices are disadvantaged in value-based payment programs, due to patient complexity and research costs. This assumption not been tested. The Oncology Care Model (OCM) was a Medicare alternative payment model, which sought to curb costs while improving care. We assessed the impact of clinical trial (CT) participation on two outcomes: 1. cost and 2. practice performance among three participating NCI designated cancer centers using a random effects meta-analysis. The mean total Medicare cost per episode was $42,225 for CT episodes and $34,937 for non-CT episodes. Despite higher total costs, CT episodes were more likely to be under spending targets than non-CT episodes (odds ratio 0.37 (CI 0.25, 0.48). Drug costs in CT episodes were lower than in non-CT episodes, although this was only statistically significant at the largest volume practice. In conclusion, CTs may offer an advantage in value-based programs.