The value of clinical trial medication and yearly medicine cost avoidance from clinical trials conducted by the pharmaceutical industry in Finland

M. Bengtström, N. Tamminen, Niina Laaksonen, S. Pakkala, A. Juppo
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Abstract

Background: Clinical trials have been reported to cause medication cost avoidance (MCA) for hospitals and societies, but there are no studies documenting MCA from the Nordic countries or from the pharmaceutical industry perspective. Methods: Three different methods were tested for determining the yearly MCA in clinical trials conducted by the pharmaceutical industry in Finland. MCA was evaluated with questionnaires to pharmaceutical companies operating in Finland in 2001, 2009 and 2013. Results: In method 1 (year 2001), the MCA in Finland was 70.3 million euros in wholesale price and 50.9 million euros when excluding patients receiving placebo treatment. In method 2 (2009), the MCA was 52.0 million euros in wholesale price and 71.0 million euros in out-sale price i.e. including pharmacy fee and tax. The MCA in method 3 (2013) was 47.2 million euros in wholesale price. The collection of data and the MCA calculation was simple in method 1 (response rate 100%). The methods 2 and 3 were more precise but more time-consuming for the respondents, somewhat affecting the response rate (response rates 90% and 72%, respectively). Conclusions: All three methods covered the majority of industry-sponsored clinical medicine trials (64-100%) representing 59-63 % of all clinical trials conducted in Finland in those years. Regardless of the methods, the study medications provided by the pharmaceutical industry promoted significant cost saving for the society. We recommend method 1 for a general and less time consuming MCA calculation and method 3 for a more precise calculation, to be conducted in survey format and interview.
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芬兰制药业临床试验用药价值及每年避免临床试验的药费
背景:据报道,临床试验导致医院和协会的药物成本规避(MCA),但没有研究记录来自北欧国家或制药行业的MCA。方法:在芬兰制药行业进行的临床试验中,测试了三种不同的方法来确定年度MCA。分别于2001年、2009年和2013年对在芬兰经营的制药公司进行问卷调查。结果:在方法1(2001年)中,芬兰的MCA批发价为7030万欧元,不包括接受安慰剂治疗的患者时为5090万欧元。在方法2(2009)中,MCA批发价为5200万欧元,销售价为7100万欧元,即包括药房费用和税收。方法3(2013)的MCA批发价为4720万欧元。方法1的数据收集和MCA计算简单(应答率100%)。方法2和方法3更精确,但更耗时,在一定程度上影响了应答率(应答率分别为90%和72%)。结论:这三种方法涵盖了大多数行业资助的临床医学试验(64-100%),占芬兰那些年进行的所有临床试验的59- 63%。无论采用何种方法,制药行业提供的研究药物为社会节省了大量成本。我们建议采用方法1进行一般且耗时更少的MCA计算,方法3采用更精确的计算,以调查和访谈的形式进行。
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