Economic benefit of NINDS-supported clinical trials estimated at more than $15 billion

in QALY, multiplied by average economic productivity, minus the increase in costs related to the tested therapies and the total cost of the clinical trials.

Among the eight trials with adequate data for analysis are some of NINDS' best-known successes. One was a trial of tissue plasminogen activator (t-PA) for ischemic stroke that showed that t-PA could prevent brain damage if used within the first three hours after a stroke begins. Another was the Randomized Indomethacin Germinal Matrix/Intraventricular Hemorrhage Prevention Trial, which showed that using indomethacin in premature babies can prevent brain hemorrhage. Each of these studies had an estimated net benefit of more than $6 billion over 10 years.

In spite of this, the analysis did not include the benefits of many other trials for which information on impact was incomplete. Many of these trials have greatly changed clinical practice and have probably had a major public health impact, such as a study that established the use of methylprednisolone after spinal cord injury, the researchers note. Therefore, the total benefits of the research program are likely underestimated, they say.

The study also did not estimate the potential economic and health impact of less obvious results from the clinical studies. For example, clinical trial results might change the use of treatments similar to the one(s) that were tested. The trial results might also lead to new basic research discoveries. "We made no attempt to value the scientific discoveries and methodological advances from clinical trials; as some of the most highly cited publications in the literature, this impact is probably substantial," the researchers say.


Contact: Natalie Frazin or Margo Warren
NIH/National Institute of Neurological Disorders and Stroke

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