The incorporation of health economic evaluations (HEEs) alongside clinical trials in Australia is on the rise, signaling a shift towards integrating economic evidence into health system management. A recent observational study published in Trials Journal highlights this trend, emphasizing the importance of HEEs in informing decisions about healthcare investments and resource allocation.
The study, which analyzed 9251 randomized Australian-led clinical trials, revealed that 11% proposed a health economic evaluation. Notably, trials run by the Australian Clinical Trials Alliance (ACTA) networks showed a significantly higher proportion (43%) of HEEs, nearly four times the proportion of all trials. This underscores the critical role of clinical trial networks in championing the inclusion of economic considerations in clinical research.
Government Funding and Acute Care Trials
The research further delved into acute care trials, identifying 324 completed trials, including those in emergency medicine, critical care, injury, and surgery. Approximately 16% of these trials proposed a health economic evaluation, while ACTA network acute care trials showed a much higher rate of 53%. A significant finding was that acute care trials funded by government bodies were more likely to propose and publish a health economic evaluation than those funded by other sources, even after adjusting for factors like trial phase and sponsor type.
The Value of Health Economic Evaluations
As healthcare budgets tighten and resources become more constrained, the results of health economic evaluations are gaining importance. These evaluations provide crucial information for both publicly and privately funded health systems, enabling them to justify investments in specific interventions, technologies, or programs. Moreover, HEEs can inform decisions about disinvesting in costly interventions that do not yield adequate health gains.
"Health economic evaluations alongside clinical trials are important for improving initial adoption decisions, examining the cost-effectiveness of interventions, addressing the requirements of regulatory bodies, and affecting reimbursement decisions for new medical technologies," the study authors noted.
Enhancing Capacity and Implementation
The study emphasizes the need to increase capacity for conducting health economic evaluations alongside clinical trials. This can ensure that investments are made in evidence-based interventions that maximize value, reducing costs while maintaining or improving health outcomes. Furthermore, the authors highlight the importance of measuring implementation strategies, outcomes, and costs in clinical trials to understand how to efficiently translate research findings into practice.
Limitations
The authors acknowledge some limitations, including the potential for inaccuracies in trial registrations and the inclusion of phase 2/3 trials that may not have been suitable for HEEs. However, they maintain that the study's robust methodology and validation through subgroup analysis support the validity of the findings.
