Abstract
Beginning around 1990, academic medical centers have ceased to be the primary locus of industry-sponsored clinical trial activity. Instead, clinical trials have increasingly been conducted in private practices and for-profit, dedicated study sites. We examine the underlying causes of this startling evolution. On the demand side, the greater availability of non-academic investigators has enabled pharmaceutical firms to better match physicians' skills with specific projects. On the supply side, we argue that the growth of managed care health insurance has contributed to a rise in the number of non-academic physicians performing clinical research. We find evidence consistent with these claims using a unique data set containing information about 85,919 site contracts for 7,735 clinical trials between 1991 and 2003. Furthermore, we examine the gap in prevailing prices for comparable procedures conducted for clinical trials versus conventional medical care, and conclude that the effect of managed care on entry is consistent with non-academic physicians “inducing demand” so as to resist downward pressures on their income.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
