Friday, January 23, 2009

GLOBAL FINANCIAL CRISIS AND CLINICAL TRIALS

I have just read from "heart.org " that clinical trials has seen her first casualty in the global financial crisis. COGENT 1 is a clinical trial, targeted to enroll 4,000 patients, over 500 sites in USA, Canada, Mexico, Europe, with a followup of 12 months. They were testing a combination pill of clopidogrel+omeprazole versus clopidogrel alone, in ACS, post-STEMI and post DES patients, to see if the combo pill have less GIT side effects. The study was sponsored by Cogentus Pharmaceuticals of USA. They began enrolment in early 2008. In December, the trial was abruptly stopped, citing financial reasons. Now the researchers have trouble trying to finance the followup of patients and all the staff that had been hired.
Looks like the global financial crisis has hit the medical shores. In fact I have been repeated spoken to, to remind me that the many CME programs that I help organise may run into financial trouble, as pharmas that support us find sales dropping and their coffers thinning out. I have been asked not to expect too much and to be thrifty. As a matter of fact, we have been very thrifty in the many CMEs that we conduct, making sure that everything is transparent and that we do not waste. Running clinical meetings with an attendance of 600, at the cost of RM 110K at a conference venue in the Klang Valley, I think is cost effective. I hear of clinical meetings running to over a million dollars locally, with attendance far less then 600. I am not sure how the organisers can hope for support, unless there is severe arm twisting going on ( something that poor us cannot do ).
Doctors must begin ( if they do not already know ) that CMEs and study trips abroad that they are sometimes send to, comes from marketing and promotional budget of the pharmas, and will go back to cost of products. The famous cliche is that there is no free lunch. I know of " big " consultants who travel for international conferences every month on drug or device companies, business class, sometimes with accompanying relatives, who are also taken shopping overseas. well lets see what happens with this credit crunch ahead of us.
As for me, we have tightened up our belts, in an attempt to survive, and continue to provide our patients with affordable cardiac care.
In short, Wall Street USA has hit main street USA, and I suspect also main street Malaysia. Let us all hope that our patients do not suffer.

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