Abstract P3-12-06: Saving in clinical trials: A possible challenge for improving health care for breast cancer patients
Authors: C Taverniti, C Bonfadini, M Pradotto, C Cagnazzo, P Demartini, L Rossi, G Ignazzi, F Arizio, A Beano
Journal: Cancer Research (2017)

Abstract Background: The economic crisis that has characterized recent years has required a careful spending review worldwide and particularly in Italy Health Care System. This resulted in substantial cuts in terms of services and drugs prescriptions. For this reason, it becomes very important to adopt measures aimed to save health care costs, maintaining at the same time the highest standard of health care. The enrollment in clinical trials (CTs) may encourage this goal, making high-cost drugs available. Methods: We compared the overall expenses for an oncology patient treated with standard therapy (reference: public hospital price list) to a similar patient enrolled in a CT. The cost comparison was made considering a patient affected by Her2 positive breast cancer in three different settings: neoadjuvant, adjuvant, and advanced/metastatic disease. We considered three categories of cost: diagnostic procedures; drug purchase; drug management. All analyses were performed considering an average treatment period and dose, calculated on a middleweight patient. We take into account the absolute saving in Euro (€) and the percentage one. Results: The data show a saving in all treatment lines, referring to the analyzed cost groups. In neoadjuvant setting, the estimated patient standard cost is 92.829,00€; we calculated a saving of 92.451,00€ (93,74%), of which 1.226,00€ for diagnostic procedures charge (65%), 89.205,00€ for drug purchase (100%) and 2.020,00€ for drug management (116%). In adjuvant setting, where the estimated standard cost is 25.527,00€, we observed a saving of 23.332,00€ (51%): 22.392,00€ (98% of drug purchase) and 940,00€ (54%) for drug management; no saving for diagnostic procedures. Regarding the metastatic breast cancer treatment, we calculated a saving of 115.158,00€ (88%) compared to 115.571,00€, that means the estimated standard cost. In this case the saving is allocated as follows: 750,00€ for diagnostic procedures (64.5%), 113.508,00€ for drug purchase (100%) and 900,00€ for drug management (100%). Conclusions: CTs are useful in order to save money in the overall patient management, allowing them to have access to expensive innovative drugs. Moreover, we have to consider the additional fees provided by Sponsor for each enrolled patient. This basic model of cost analysis could be used by Institutional Health Care stakeholders for spending review strategies. The public institutes with the characteristics of Comprehensive Cancer Center are essential to recruiting the needed study population for Sponsorized CTs, and the cashed and saved money can be reinvested for improving Breast Cancer patients care.Background: The economic crisis that has characterized recent years has required a careful spending review worldwide and particularly in Italy Health Care System. This resulted in substantial cuts in terms of services and drugs prescriptions. For this reason, it becomes very important to adopt measures aimed to save health care costs, maintaining at the same time the highest standard of health care. The enrollment in clinical trials (CTs) may encourage this goal, making high-cost drugs available. Methods: We compared the overall expenses for an oncology patient treated with standard therapy (reference: public hospital price list) to a similar patient enrolled in a CT. The cost comparison was made considering a patient affected by Her2 positive breast cancer in three different settings: neoadjuvant, adjuvant, and advanced/metastatic disease. We considered three categories of cost: diagnostic procedures; drug purchase; drug management. All analyses were performed considering an average treatment period and dose, calculated on a middleweight patient. We take into account the absolute saving in Euro (€) and the percentage one. Results: The data show a saving in all treatment lines, referring to the analyzed cost groups. In neoadjuvant setting, the estimated patient standard cost is 92.829,00€; we calculated a saving of 92.451,00€ (93,74%), of which 1.226,00€ for diagnostic procedures charge (65%), 89.205,00€ for drug purchase (100%) and 2.020,00€ for drug management (116%). In adjuvant setting, where the estimated standard cost is 25.527,00€, we observed a saving of 23.332,00€ (51%): 22.392,00€ (98% of drug purchase) and 940,00€ (54%) for drug management; no saving for diagnostic procedures. Regarding the metastatic breast cancer treatment, we calculated a saving of 115.158,00€ (88%) compared to 115.571,00€, that means the estimated standard cost. In this case the saving is allocated as follows: 750,00€ for diagnostic procedures (64.5%), 113.508,00€ for drug purchase (100%) and 900,00€ for drug management (100%). Conclusions: CTs are useful in order to save money in the overall patient management, allowing them to have access to expensive innovative drugs. Moreover, we have to consider the additional fees provided by Sponsor for each enrolled patient. This basic model of cost analysis could be used by Institutional Health Care stakeholders for spending review strategies. The public institutes with the characteristics of Comprehensive Cancer Center are essential to recruiting the needed study population for Sponsorized CTs, and the cashed and saved money can be reinvested for improving Breast Cancer patients care. Citation Format: Taverniti C, Bonfadini C, Pradotto M, Cagnazzo C, Demartini P, Rossi L, Ignazzi G, Arizio F, Beano A. Saving in clinical trials: A possible challenge for improving health care for breast cancer patients [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-12-06.