Collaborative Research: TLS: An Experimental Producer Price Index for Clinical Trials

项目描述。临床试验是医疗保健研发的重要组成部分，本课题研究构建临床试验价格指数的可行性。增加卫生保健研发支出是一个重要的政策问题，但如果不知道这些增加是由于生物医学研究投入价格的变化，还是由于正在进行的研究数量的变化，就很难评估支出的变化。该项目构建了一个“价格平减指数”，将总支出的增长分解为价格和数量两个部分。这些价格指数中很少是专门为科学研究构建的，尤其是因为研发活动往往是高度异质的，因此很难进行有意义的年与年或不同背景的比较。足够详细的数据使得既可以进行价格比较，保持恒定的因素，如临床开发阶段，治疗领域和患者数量，并控制与不同试验设计相关的复杂性和工作负担。使用的方法“享乐价格分析”已经在许多领域建立了良好的基础，例如构建it产品的平减指数，但以前没有应用于科学研究活动。这些价格指数，结合在诸如clinicaltrials.gov等公共登记处公布的临床试验活动数据，可以对按州、国家和研发人员类型划分的临床试验支出进行广泛的估计。更广泛的影响。除了关于临床研究价格演变的证据外，该项目还揭示了与将研发投资纳入国民收入账户有关的一些方法问题，并为围绕美国研发的“外包”和“离岸”以及美国医学研究机构的全球竞争力的重要政策辩论提供了信息。临床试验越来越多地在传统的美国学术医疗中心之外进行，在医生办公室、诊所和提供者网络中，以及由专门的营利性实体进行。此外，试验已经变得越来越全球化，一个单一的方案从许多不同国家的地点收集数据。临床试验的这些新特征是研发活动在地域、参与者和机构之间的分布正在发生的更广泛变化的一个例子。这个研究项目有助于更好地理解这一现象背后的经济力量。经济分析局和其他机构可以使用这种方法来估计研发对实际和名义国内生产总值的影响，甚至在州或区域一级，这是很难用目前的数据做到的。

Project Description.This research project studies the feasibility of constructing price indexes specifically for clinical trials, an important component of healthcare R&D. Increasing health care R&D spending is an important policy issue, but changes in expenditure are very difficult to evaluate without knowing whether these increases are due to changes in the prices of inputs to biomedical research, as opposed to changes in the quantity of research being performed.Intellectual MeritThe project constructs a "price deflator" that decomposes growth in total expenditure into price and quantity components. Very few of these price indexes have been constructed specifically for scientific research, not least because R&D activities tend to be highly heterogeneous, and therefore difficult to compare meaningfully year-to-year or across different contexts. Sufficiently detailed data make it possible both to make price comparisons that hold constant factors such as the stage of clinical development, therapeutic area, and number of patients, and to control for the complexity and work burden associated with different trial designs, The methodology that is used "hedonic price analysis" has been well-established in many areas, such as constructing deflators for IT products, but not has not previously been applied to scientific research activity. These price indexes, combined with data on clinical trial activity published in public registries such as clinicaltrials.gov, allow the construction of broad-based estimates of clinical trial expenditures broken out by state, country, and type of R&D performer. Broader Impact.Along with evidence on the evolution of the price of clinical research, this project sheds light on a number of methodological issues relating to the integration of R&D investment into the national income accounts, and informs important policy debates surrounding the "outsourcing" and "offshoring" of US R&D, and the global competitiveness of American medical research establishments. Clinical trials are increasingly being performed outside traditional US academic medical centers, at physicians' offices, clinics, and provider networks, as well as by specialized for-profit entities. Moreover, trials have become increasingly global, with a single protocol collecting data from sites in many different countries. These new features of clinical trials are one example of broader changes under way in the distribution of R&D activity across geographies, actors, and institutions. This research project helps develop a better understanding of the economic forces underlying this phenomenon.This approach can be used by BEA and other agencies in developing estimates of the impact of R&D on real and nominal gross domestic product, even at the state or regional level, which is very difficult to do with current data.