Funding characteristics of randomised clinical trials supported by the main public funding body in Switzerland: a retrospective cohort study

Article type
Authors
Amstutz A1, Schandelmaier S2, von Niederhäusern B3, von Elm E4, Briel M1
1Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, Spitalstrasse 12, 4031 Basel, Switzerland
2Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
3Clinical Trial Unit, Department of Clinical Research, University Hospital Basel, 4031 Basel, Switzerland
4Cochrane Switzerland, Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
Abstract
Background: The Swiss National Science Foundation (SNSF) is the main public funding body for basic and clinical research in Switzerland. Results from a retrospective cohort study including 101 SNSF-supported randomised clinical trials (RCTs) showed that 40% were not published in peer-reviewed journals. Funding characteristics (e.g. total trial costs, funding per participant, additional funding sources) of SNSF-supported RCTs have not been investigated before.

Objectives: To assess the funding characteristics of RCTs supported by the SNSF until 2015 and to compare results to those from a similar UK study.

Methods: We established a retrospective cohort of SNSF-supported RCTs for which recruitment and funding had ended in 2015 or earlier. For each RCT, two investigators independently searched corresponding publications in electronic databases and trial registries. We asked all principal investigators in an online survey for information about funding characteristics and completion/publication status. Teams of two investigators independently extracted details from the original SNSF proposal and, if available, from trial registries or publications.

Results: We included 101 SNSF-supported RCTs between 1986 and 2015. Most were single-centre RCTs with median study size of 138 (interquartile range [IQR], 76-400). Sixty-seven principal investigators (67%) responded to our survey. On average, investigator-initiated RCTs received $220,000 (≙CHF 222,000) from the SNSF, covering 67% of the total trial costs. Most investigators (70%) mentioned additional funding, mainly from own institution or private foundations. Median total costs of an SNSF-supported RCT were $426,000 (IQR, $280,000-$892,000). Funding characteristics were similar to a study from the UK (McDonald et al.; Trials. 2006). More than $12 million (i.e. 49% of RCT budget spent by SNSF until 2015) was granted to RCTs that were never published.

Conclusion: To avoid waste of public resources for health research, public funders could promote publication of RCTs and improve funding schemes for investigator-initiated RCTs. A new SNSF funding track aims to address this issue, but needs to be evaluated.