Should Hospitals Do Contract Research? Costs, Net Monetary Benefit, and Return on Public Sector Investments in Research at Kuopio University Hospital
Väätäinen S1, Soini E2, Töyräs J3
1ESiOR Oy, Kuopio, Finland, 2ESiOR Oy, Kuopio, 15, Finland, 3Kuopio University Hospital, Wellbeing Services County of North Savo, Kuopio, Finland. Department of Technical Physics, Faculty of Science, Forestry and Technology, University of Eastern Finland, Kuopio, Finland
OBJECTIVES: Health technology innovations such as pharmaceuticals and medical devices often require clinical research evidence and health technology assessments (HTA) for market authorisation, labelling, market access, and product lifecycle management. However, research itself is rarely subjected to HTA.We conducted an HTA of public sector investments in the contract research of Kuopio University Hospital (KUH), the primary specialised care provider for almost 800,000 Finns, evaluating how the public sector may benefit from contract research.
METHODS: Three scenarios were assessed: 1) No change to investments in research activity and infrastructure, 2) an increase in annual investments by approximately 50 %, and 3) complete discontinuation of investments.Outcomes included observed costs, net monetary benefit (NMB), and return on investment (ROI) during years 2015-21, and predicted NMB between 2023-32. The assessment was based on data from public sources, university hospital statistics, employee surveys, benchmarking, and stakeholders. Costs covered research, employment, support, facilities, and personnel recruitment costs. Benefits included study pharmaceutical, treatment, other, and contract investment benefits. The NMB was estimated realistically for the public payer (new drugs: 49,940€/QALY; other direct health benefits: 30,736€/QALY). Sensitivity analyses covered very conservative and no valuation of health benefits.
RESULTS: The total NMB was 258M€ in 2015-21 with a ROI of 292%. If investments would remain at the current level, annual NMBs were predicted to decrease by 21%, from 42M€ to 33M€, by 2032. With additional investments, total predicted additional cumulative NMB was estimated at 241M€ by 2032 (annual 80M€ in 2032). Discontinuing the investments would result in a negative NMB in 2032.
CONCLUSIONS: In 2015-21, one euro invested in research returned almost four euros to the KUH catchment area. Additional investments were estimated to further increase the NMB. However, further studies are warranted as our assessment likely underestimates the total and especially the indirect effects of research.
Conference/Value in Health Info
Value in Health, Volume 26, Issue 11, S2 (December 2023)
Economic Evaluation, Health Technology Assessment
Cost-comparison, Effectiveness, Utility, Benefit Analysis, Systems & Structure, Thresholds & Opportunity Cost
Drugs, Medical Devices, No Additional Disease & Conditions/Specialized Treatment Areas, Personalized & Precision Medicine