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[ Conrad Notes Index | ASH Index ]
a timely medical meeting newsletter
WHO SHOULD PAY FOR BASIC RESEARCH AND CLINICAL TRIALS?
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J. Stossel, ABC News, New York, NY, chaired a panel selected
from government, oncology, and managed care to help answer this
important question. Each presenter offered insight and advice
for a highly expectant public and equally concerned physicians.
Our limited financial resources demand changing the present
methods for financing basic research and clinical trials.
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| Lenfant gives US government perspective | C. Lenfant, MD, National Heart, Lung and Blood Institute, NIH,
Bethesda, MD, highlighted some benefits from NIH-supported
research. The last 47 years saw a 59.5% decline in the death
rate from coronary heart disease. Life expectancy increased by
5.6 years between 1965 and 1995. Lenfant expressed concern about
current budgetary constraints. Limited federal funding will
impede the flow of eligible study patients and qualified clinical
investigators.
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| Views of two clinicians | T. Stossel, MD, American Society of Hematology (ASH) President,
Brigham and Women's Hospital, Boston, Mass, called attention to
several important medical advances presented initially at ASH
meetings. Bone transplants and the cures of childhood leukemia
and lymphoma were first presented at ASH meetings. Reports at
this year's meeting on basic blood coagulation research led to
reduced patient morbidity and mortality. Stossel advised the
specialists, "We have not worried enough about actuarial matters
in the past. Someone has to pay the bills for basic and clinical
research ... Like it or not, raising the money for those bills
involves the political process."
J. Armitage, MD, former President of the American Society of Clinical Oncology (ASCO), University of Nebraska, Omaha, spoke about the goals of clinical research and current funding sources. In the nonprofit setting, the goals are improving the survival of people, curing fatal disease, decreasing suffering, and sometimes lowering the cost of health care. Armitage identifies funding sources for clinical research as the National Institutes of Health (NIH), pharmaceutical and device companies, patients through third-party payers to cover healthcare costs, donors, in addition to others who provide "in kind" support such as universities, hospitals, and physicians. NIH needs to become more efficient in patient enrollment, recruiting and training clinical investigators, and funding cancer clinical research, according to the Armitage Commission report.
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| Newcomer speaks for United HealthCare Corp | L. Newcomer, MD, Chief Medical Officer at United HealthCare Corp,
Edina, Minn, presented as a trained research oncologist, business
manager, and proprietary medical provider affecting 14 million
individuals. The cost of conducting medical research can be
lessened by reducing duplication of effort and completing more
trials. For example, the 1997 May/June issue of Cancer Clinical
Trials, according to Newcomer, shows 32 active studies on high-dose
chemotherapy with hematologic rescue. Only 4 of the 32 could
result in information on the usefulness of the treatment; the
remaining 28 studies involve case series. With prodding, the
National Cancer Institute (NCI) recently installed a procedure to
track clinical trial results for estimating wasted effort and
funding. The limited financial resources supporting US medical research prompt Newcomer to recommend open debate on these issues:
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| J. Stossel expresses concern | As a skeptical outsider to research, Stossel does not feel that
the taxpayer should pay. Researchers need to participate in the
debate to convince the public to pay for basic and clinical
research. Stossel advises clinicians to speak up and point out
medical advances in lay terminology to inform the public why
government should be funding medical research and not cutting
back.
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| Conrad comments | This Panel agreed that answering the "who pays" question needs
open debate by the major players. Managed care, represented by
Dr. Newcomer, offerred an agenda for The Debate. No one can
disagree with the advances made by NIH's support of clinical
research and physician training. Duplicative cancer research is
an expensive way to train specialists. Perhaps a less costly
method can be devised.
For correspondence, please contact John Stossel by E-mail at: stossel@abc.com |
Presented at The American Society of Hematology (ASH) Meeting, December 5-9, 1997
Copyright © 1998 Conrad Group, Inc. All Rights Reserved
Eugene A. Conrad, PhD, MPH / ISSN 1078-2230 / February 1998
Send comments to: ConradNote@aol.com
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