Collaboration in academia designed to increase return on research investments

  • HemOnc Today, January 25, 2013

One of the cornerstones of the project will be research databases and clinical informatics, Nelson said. Fred Hutchinson Cancer Research Center will provide foundational investments for data processing and the creation of a regional oncology databank in collaboration with NCI to identify real patterns of care among cancer patients.

“The issue of outcomes and cost-effectiveness is relevant throughout the spectrum, whether you are talking about prevention, diagnosis, treatment or long-term care,” Nelson said. “The idea is to improve the efficiency and effectiveness of cancer care for all 
patients.”

ICORE will identify and implement new models that will minimize the financial burden on patients while maintaining the quality of care, according to Scott Ramsey, MD, PhD, who has been appointed as its first director.

“The institute will serve as a new model for partnerships with all stakeholders in the cancer research and care delivery enterprise,” Ramsey said. “Success in this effort will result in broader use of evidence-based care, more efficient and effective models of health care delivery, and reducing the overall burden of cancer.” – by Anthony Calabro

References:

American Cancer Society. Cancer Facts & Figures 2012. Atlanta, GA: American Cancer Society; 2012.

Best hospitals in Ohio. U.S. News and World Report. Available at: http://health.usnews.com/best-hospitals/area/oh. Accessed on Dec. 19, 2012.

Hennessy BTJ. J Clin Oncol. 2010;28:3570-3576.

Institute of Medicine of the National Academies. Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. Washington, D.C.: National Academy of Sciences; 2012.

Mariotto AB. J Natl Cancer Inst. 2011;103;117-128.

For more information:

Chris Coburn can be reached at Innovations at Cleveland Clinic, 9500 Euclid Ave., GCIC10, Cleveland, OH 44195; email: coburnc@ccf.org.

Brian Cummings can be reached at Technology Commercialization and Knowledge Transfer Office, Ohio State University, 1524 N. High St., Columbus, OH 43201; email: cummings.244@osu.edu.

Ronald DePinho, MD, can be reached at The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030.

Frank McCormick, PhD, FRS, can be reached at University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, Box 0128, UCSF, San Francisco, CA 94143-0128; email: director@cc.ucsf.edu.

Gordon B. Mills, MD, PhD, can be reached at the Department of Systems Biology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030.

Judy Nelson can be reached at Fred Hutchinson Cancer Research Center, Department of Public Health Sciences, 1100 Fairview Ave. North, P.O. Box 1902, Seattle, WA 98109-1024; email: jnelson@fhcrc.org.

Scott Ramsey, MD, PhD, can be reached at Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. North, M3-B232, P.O. Box 19024, Seattle, WA 98109-1024.

Disclosure: Coburn, Cummings, DePinho, McCormick, Mills, Nelson and Ramsey report no relevant financial disclosures.

POINTCOUNTER

Will innovative partnerships benefit from an infusion of research funding?

POINT

Private-public partnerships are a very good option.

There are certain realities that exist in 2013. The first is that overall reimbursement in health care is declining and will continue to do so. Everyone in health care will be paid less for what they do. Second, given the current state of the budget deficit, federal funding for grants will not increase and may very likely decrease.

For any major academic medical center, covering research costs is going to be an increasing challenge. Academic centers will need to be creative at finding alternative revenue streams to try to maintain their academic missions. One of those ways may be philanthropy. Some academic centers do that very well. But depending on how the economy fluctuates, philanthropic support is a variable that is difficult to predict.

Because the cost of clinical research continues to rise, in part due to the regulatory scrutiny that exists, it is very difficult for many private oncology groups to offer clinical research to their patients. They simply do not have a practice model to cover the costs associated with clinical research and, therefore, are frequently anxious to partner with an academic cancer center to be able to offer these services to their patients. These private oncology groups are willing to pay for that service.

From an academic medical center perspective, there are several possible benefits. The first is the more that we increase our opportunities and capacities to accrue patients to clinical research trials, the better. That’s a very important part of our academic mission. If we can use these partnerships to maintain our academic mission, then it is likely worthwhile.

Second, these partnerships do create a revenue stream to the academic center to help defray some costs associated with research. Frequently, these partnerships have agreements that include a variety of other components besides research, so the revenue back to the academic center covers additional organizational parts, but some revenue does support research.

We are all going to have to be creative in finding additional ways to conduct both basic translational and clinical research. I think these partnerships represent a very real and viable option to assist research costs and maintain our academic mission.

Brian J. Bolwell, MD, FACP, is chairman of the Taussig Cancer Institute at Cleveland Clinic. He can be reached at Cleveland Clinic Main Campus, Mail Code R32, 9500 Euclid Ave., Cleveland, OH 44195; email: bolwelb@ccf.org. Disclosure: Bolwell reports no relevant financial disclosures.

COUNTER

These partnerships are not so much financially driven as they are driven by the nature of the field.

The world has changed. The science and technologies we need to develop a comprehensive picture of cancer is often outside the capacity of any one institution. Collaborations are becoming more common because they are science-driven.

I see innovative partnerships as an opportunity, but also as an obligation. The public, the NCI and the NIH expect these essential collaborations, which enable us to bring cancer discoveries into the clinic. When they are driven only by financial factors, you have a much higher chance of failure because the entities involved may have different goals and different cultures, and you are trying to blend different interests. If these collaborations are strictly financially driven, you also encounter problems managing conflict of interest on the key issues.

Clearly, there are many different types of collaborations. Some of them, like partnerships between pharmaceutical companies and academic institutions, are often both scientifically and financially driven. Academic institutions are looking to pharma for components of drug development that we can’t accomplish and are not really the forte of universities. At the same time, pharma is looking to us for the clinical relevance, for identifying targets, validation and — of course — clinical trials.

In those cases, there are financial ramifications because academia cannot conduct these studies without financial support from pharmaceutical companies. This is where managing conflict of interest becomes a high priority. Most institutions have done a very credible job of developing firewalls and creating strong guidelines that prevent those individuals in a position of authority from unduly influencing the conduct of research, including clinical trials.

Michelle M. Le Beau, PhD, is director of the Cancer Cytogenetics Laboratory at University of Chicago. She can be reached at The University of Chicago, AMB H212Q (MC 1140), 5841 S. Maryland Ave., Chicago, IL 60637; email: mlebeau@medicine.bsd.uchicago.edu. Disclosure: Le Beau reports no relevant financial disclosures.