ACTA’s submission to the Senate Inquiry into Australia’s Innovation System was published today.
We welcomed the opportunity to highlight to the Economic Reference Committee the following key points, along with a series of reforms that would substantially improve the efficiency with which trials generate evidence and their capacity to advance healthcare.
Clinical trials are an essential component of a knowledge-based economy:
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Clinical trials are a fundamental component of the innovation ‘pipeline’ for health and medical discovery. Clinical trials, at the final stage of the ‘pipeline’, are the principal vehicle or tool to determine if an innovation actually works.
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Many health innovations fail at the stage of final clinical testing (and after enormous investment), not because the innovation necessarily lacks effectiveness, but because of flaws in the design, execution and analysis of clinical trials. Australia is a world leader in clinical trials but this expertise is not leveraged to create the global industry leadership that is possible.
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The investigator-led clinical trials sector shares its workforce with industry-sponsored trials that drive commercial development and, as a consequence, contributes substantially to the training and workforce development that makes Australia an attractive destination for in- bound investment in clinical trials.
Clinical trials and clinical quality registries can improve national productivity by creating better health whilst constraining healthcare spending:
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From the perspective of a nation’s wealth, the healthcare system is relevant in two countervailing ways. Effective healthcare enhances and prolongs the productivity of the workforce, but its provision is an opportunity cost corresponding to a substantial proportion of gross domestic product.
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There is overwhelming evidence that outcomes from healthcare (i.e. the generation of health) are variable, that the effectiveness of many treatments in widespread use has not been established, and that a substantial proportion of healthcare spending is wasted.
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The systematic application of clinical trials (to establish effectiveness and cost-effectiveness) and clinical quality registries (to monitor whether treatments are being utilised appropriately and measure patient outcomes) are the best and most rational approach to improving the quality of healthcare and reducing healthcare expenditure.
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Such trials are most usually and most effectively conducted by networks of clinicians who understand the existing evidence base and are therefore most likely to adopt the outputs of their research findings. However, at this point in time there is minimal support for the critical infrastructure that enables these networks.
The efficiency of conducting clinical trials can be vastly enhanced if they are integrated as a routine component of healthcare delivery:
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Clinical trials, as they are currently conducted, are often expensive- sometimes prohibitively so. This is predominantly because trials are conducted, and funded, as an activity that is separate to healthcare delivery.
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The healthcare system can and should conduct trials as part of its ‘core business’ because the healthcare system provides treatments and measures (or should measure) outcomes. All that is needed to modify this to conduct trials is to create opportunities for treatments of uncertain effectiveness or cost-effectiveness to be studied within a trial.
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Australian clinical trial networks are global leaders in creating innovative opportunities to conduct trials as a routine component of healthcare delivery.
ACTA's full submission can be read here.
The Inquiry was referred to the Senate Economics Reference Committee in March 2014 to report on the challenges to Australian industries and jobs posed by increasing global competition in innovation, science, engineering, research and education.
The report, due to be handed down in July 2015 will focus on several key areas impacting Australia's growth and prosperity, including research and the translation of research into direct social and economic benefits for Australians.
For further information about the Senate Inquiry into Australia's Innovation System visit http://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Economics/Innovation_System