How can the wider New Zealand ecosystem augment the strong clinical trials sector?
Across New Zealand, health system decision-making often does not facilitate research activity and, in many cases, can be a barrier to research.
A paper published by the NZ Institute of Economic Research in 2020, notes that clinical research in NZ is broad in scope. The full spectrum of interventional studies takes place in NZ, including all phases of the medicines development process (Phase I first-in-human trials through to Phase IV post-approval studies), as well as studies of medical devices, natural health products, and other interventions (diet, physiotherapy etc).
Local trials benefit patients, clinicians and the wider population. Benefits to trial participants also come in the form of saved Quality Adjusted Life Years (QALYs) or Disability Adjusted Life Years (DALYs). The benefits for District Health Boards and Primary Care Providers include access to therapies that are unavailable in NZ as they are not registered and/or funded here. As well as providing revenue, there are benefits for both students, researchers and institutions. For post-graduate students, clinical trials provide the opportunity of being involved with applied research. Research associated with trials may provide suitable topics for research masters and PhDs.
In 2018, SCOTT trials (Standing Committee on Therapeutic Trials) directly accounted for $127.4 million of NZ’s total GDP, directly employed 753 staff and played an important role in supporting activity in other parts of the New Zealand economy by purchasing supplies from them. This is known as an indirect contribution. The SCOTT trials sector purchased $44 million of inputs from supporting sectors in 2018.
Even though our economic contribution estimates are conservative, SCOTT trials appear to be contributing more to GDP relative to NZ population than those being carried out in Hungary, Ireland and Thailand, but less than Australia and the United Kingdom.
Outside of SCOTT trials, other clinical trial registries are plagued with their own errors such as missing data or double/triple counting entries. Additionally, there is a missing network that incorporates resources from both the public and private sectors where activity in one of these sectors benefits the other.
The development of a centralised repository to collect data on clinical trial activity across the wider sector would be a good step forward, wherein the wider healthcare ecosystem can augment the clinical trials sector.
Future investment in clinical trials is likely to continue to produce large health benefits. Prioritisation of trials should be based on factors such as disease burden, gaps in health outcomes between different populations, and include those areas where there may be potential to have a greater impact and return on investment.