Can Participation in Cancer Clinical Trials Save Money?

Patients with cancer who were treated as part of a clinical trial had lower costs of care than similar patients who were receiving routine care, according to an analysis from a large community-based oncology practice.

These results should reassure health insurers that are concerned that clinical trial participation can increase total costs of care for people with cancer, noted lead author Garrett Young, the Director of Clinical and Strategic Analytics at OneOncology in Nashville, Tennessee, who presented these findings at the 2021 American Society of Clinical Oncology Annual Meeting.

In this analysis, Mr. Young and colleagues estimated the impact of clinical trial participation on total costs paid by Medicare as part of the Oncology Care Model (OCM) at Tennessee Oncology, a community oncology practice comprising more than 90 oncologists across 30 sites of care.

The researchers linked trial data and electronic medical record data from Tennessee Oncology with OCM data between 2016 and 2018. They created two matched comparator groups for each OCM episode based on cancer type, metastatic status, number of comorbidities, performance status, and age to determine cost differences between trial participants and routine patients.

Of 8,026 total OCM episodes, 459 of these episodes involved patients who were enrolled in a clinical trial. Mr. Young and colleagues found that episodes among trial participants cost $5,973 less than matched non-trial episodes. According to cancer type, cost savings were greatest for myeloma and lymphoma, while the costs were substantially higher for gastroesophageal cancer (TABLE). Costs were lower regardless of trial phase, the researchers noted, and the cost savings were mostly related to decreased drug prices.

In addition, clinical trial participation did not negatively affect outcomes such as rates of active treatment in the last 14 days of life (15% for on-trial episodes vs. 14% for non-trial episodes), hospitalizations (31% vs. 30%), or hospice use (52% vs. 62%).

“In the community setting, total costs paid by Medicare for patients participating in clinical trials during OCM episodes were lower than costs for similar patients receiving routine care,” the authors concluded. While this analysis suggests that trial participation does not enhance insurers’ financial risks, data was reviewed from a single community-based oncology practice and results may not be generalizable.

Study authors report no relevant conflicts of interest.

Reference

Young G, Bilbrey LE, Arrowsmith E, et al. Impact of clinical trial enrollment on episode costs in the Oncology Care Model (OCM). Abstract #6513. Presented at the 2021 American Society of Clinical Oncology Annual Meeting, June 4-8, 2021.

TABLE. Average Savings per Episode

Cancer Trial Episodes Overall

($ in Thousands)

Drug

($ in Thousands)

Inpatient

($ in Thousands)

Ancillaries

($ in Thousands)

Other

($ in Thousands)

Lung 68 16.9 19.2 –1.4 –0.6 –0.4
Breast 67 13.1 17.5 –0.5 –1.4 –2.5
Multiple myeloma 64 –1.7 5.6 –1.8 –1.9 –3.6
Small intestine/colorectal 61 0.5 –2.4 2.4 –0.5 1.0
Prostate 45 2.8 4.9 –1.5 0.2 –0.7
Lymphoma 37 –8.9 –0.9 –3.2 –2.0 –2.7
Chronic leukemia 20 5.3 3.4 1.9 –0.9 1.0
Gastroesophageal 20 13.0 2.9 2.0 0.5 7.5
All other 77 8.1 9.4 1.5 –1.6 –1.1
Total 459 6.0 8.1 –0.2 –1.1 –0.9