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Do Randomized Controlled Trials Discuss Healthcare Costs?

BACKGROUND: Healthcare costs, particularly pharmaceutical costs, are a dominant issue for most healthcare organizations, but it is unclear if randomized controlled trials (RCTs) routinely discuss costs. Our objective was to assess the frequency and factors associated with the inclusion of costs in R...

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Autores principales: Allan, G. Michael, Korownyk, Christina, LaSalle, Kate, Vandermeer, Ben, Ma, Victoria, Klein, Douglas, Manca, Donna
Formato: Texto
Lenguaje:English
Publicado: Public Library of Science 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925897/
https://www.ncbi.nlm.nih.gov/pubmed/20808794
http://dx.doi.org/10.1371/journal.pone.0012318
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author Allan, G. Michael
Korownyk, Christina
LaSalle, Kate
Vandermeer, Ben
Ma, Victoria
Klein, Douglas
Manca, Donna
author_facet Allan, G. Michael
Korownyk, Christina
LaSalle, Kate
Vandermeer, Ben
Ma, Victoria
Klein, Douglas
Manca, Donna
author_sort Allan, G. Michael
collection PubMed
description BACKGROUND: Healthcare costs, particularly pharmaceutical costs, are a dominant issue for most healthcare organizations, but it is unclear if randomized controlled trials (RCTs) routinely discuss costs. Our objective was to assess the frequency and factors associated with the inclusion of costs in RCTs. METHODS AND FINDINGS: We randomly sampled 188 RCTs spanning three years (2003-2005) from six high impact journals. The sample size for RCTs was based on a calculation to estimate the inclusion of actual drug costs with a precision of +/−3%. Two reviewers independently extracted cost data and study characteristics. Frequencies were calculated and potential characteristics associated with the inclusion of costs were explored. Actual drug costs were included in 4.7% (9/188) of RCTs; any actual costs were included in 7.4% (14/188) of RCTs; and any mention of costs was included in 27.7% (52/188) of RCTs. As the amount of industry funding increased across RCTs, from non-profit to mixed to fully industry funded RCTs, there was a statistically significant reduction in the number of RCTs with any actual costs (Cochran-Armitage test, p = 0.005) and any mention of costs (Cochran-Armitage test, p = 0.02). Logistic regression analysis also indicated funding was associated with the inclusion of any actual cost (OR = 0.34, p = 0.009) or any mention of costs (OR = 0.63, p = 0.02). Journal, study conclusions, study location, primary author's country and product age were not associated with inclusion of cost information. CONCLUSION: While physicians are encouraged to consider costs when prescribing drugs for their patients, actual drug costs were provided in only 5% of RCTs and were not mentioned at all in 72% of RCTs. Industry funded trials were less likely to include cost information. No other factors were associated with the inclusion of cost information.
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spelling pubmed-29258972010-08-31 Do Randomized Controlled Trials Discuss Healthcare Costs? Allan, G. Michael Korownyk, Christina LaSalle, Kate Vandermeer, Ben Ma, Victoria Klein, Douglas Manca, Donna PLoS One Research Article BACKGROUND: Healthcare costs, particularly pharmaceutical costs, are a dominant issue for most healthcare organizations, but it is unclear if randomized controlled trials (RCTs) routinely discuss costs. Our objective was to assess the frequency and factors associated with the inclusion of costs in RCTs. METHODS AND FINDINGS: We randomly sampled 188 RCTs spanning three years (2003-2005) from six high impact journals. The sample size for RCTs was based on a calculation to estimate the inclusion of actual drug costs with a precision of +/−3%. Two reviewers independently extracted cost data and study characteristics. Frequencies were calculated and potential characteristics associated with the inclusion of costs were explored. Actual drug costs were included in 4.7% (9/188) of RCTs; any actual costs were included in 7.4% (14/188) of RCTs; and any mention of costs was included in 27.7% (52/188) of RCTs. As the amount of industry funding increased across RCTs, from non-profit to mixed to fully industry funded RCTs, there was a statistically significant reduction in the number of RCTs with any actual costs (Cochran-Armitage test, p = 0.005) and any mention of costs (Cochran-Armitage test, p = 0.02). Logistic regression analysis also indicated funding was associated with the inclusion of any actual cost (OR = 0.34, p = 0.009) or any mention of costs (OR = 0.63, p = 0.02). Journal, study conclusions, study location, primary author's country and product age were not associated with inclusion of cost information. CONCLUSION: While physicians are encouraged to consider costs when prescribing drugs for their patients, actual drug costs were provided in only 5% of RCTs and were not mentioned at all in 72% of RCTs. Industry funded trials were less likely to include cost information. No other factors were associated with the inclusion of cost information. Public Library of Science 2010-08-23 /pmc/articles/PMC2925897/ /pubmed/20808794 http://dx.doi.org/10.1371/journal.pone.0012318 Text en Allan et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Allan, G. Michael
Korownyk, Christina
LaSalle, Kate
Vandermeer, Ben
Ma, Victoria
Klein, Douglas
Manca, Donna
Do Randomized Controlled Trials Discuss Healthcare Costs?
title Do Randomized Controlled Trials Discuss Healthcare Costs?
title_full Do Randomized Controlled Trials Discuss Healthcare Costs?
title_fullStr Do Randomized Controlled Trials Discuss Healthcare Costs?
title_full_unstemmed Do Randomized Controlled Trials Discuss Healthcare Costs?
title_short Do Randomized Controlled Trials Discuss Healthcare Costs?
title_sort do randomized controlled trials discuss healthcare costs?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925897/
https://www.ncbi.nlm.nih.gov/pubmed/20808794
http://dx.doi.org/10.1371/journal.pone.0012318
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