Commentary: Per Capita Payments in Clinical Trials: Reasonable Costs Versus Bounty Hunting

ÌÇÐÄ´«Ã½

Abstract

Paying more for clinical ÌÇÐÄ´«Ã½ than the cost of doing the work may create a conflict of interest that could lead to overzealous recruitment, putting participants and scientific integrity at risk. Thus, although various policies prohibit "finder's fees" simply for recruiting patients, paying the actual costs for ÌÇÐÄ´«Ã½ is permissible. Whereas industry-sponsored ÌÇÐÄ´«Ã½ routinely pays for the costs of each patient enrolled, the line between reasonable and excessive costs merits more attention. In academic medical centers (AMCs), institutional review boards and conflict of interest committees usually are not involved in reviewing ÌÇÐÄ´«Ã½ budgets to determine whether per capita payments are excessive. Also, the costs for clinical services in ÌÇÐÄ´«Ã½ are not standardized. Instead, budgets are negotiated both internally, among departments within ÌÇÐÄ´«Ã½ institutions, and externally, between ÌÇÐÄ´«Ã½ers and sponsors. Sometimes, rates paid by sponsors exceed what ÌÇÐÄ´«Ã½ers usually receive or are actually paid for particular services, generating a surplus. Nevertheless, the authors see only limited cause for concern because, at the AMCs with which the authors are familiar, any monetary surplus generally remains within the ÌÇÐÄ´«Ã½ enterprise to cover unanticipated budget shortfalls or to support ÌÇÐÄ´«Ã½ staff in the future during lean times. In addition, the surplus from ÌÇÐÄ´«Ã½ budgets is not shared directly with individual investigators. However, further investigation is needed to determine whether practices outside AMCs pose greater concerns.

View details for

View details for

View details for