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SPCTRM Stanford/Packard Center for Translational Research in Medicine. Stanford University School of Medicine. SARP Meeting 7/24/08 Study Budgeting Anna Hu, RN, MPH. SPCTRM website. SPCTRM calendar: http://med.stanford.edu/spctrm/education/index.html General Orientation
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SPCTRMStanford/Packard Center for Translational Research in Medicine Stanford University School of Medicine SARP Meeting 7/24/08 Study Budgeting Anna Hu, RN, MPH
SPCTRM website • SPCTRM calendar: http://med.stanford.edu/spctrm/education/index.html • General Orientation • Budgeting and Billing Training • Workshops
Case Study I-Federally sponsored, multi-site, investigator initiated study conducted on CTRU (GCRC) • Study population: age > or = 18 • Study design: Phase IV, 12 week DB, controlled trial • Will receive 1 injection weekly for 12 weeks • Evaluated monthly for safety and efficacy • Week 12 study therapy will be discontinued; subjects will be unblinded & returned to their MD for ongoing care • Week 16 safety f/u visit
Study Treatment • 1 SQ injection of 40 mg OR 1 SQ injection of placebo in a blinded and alternating fashion for 12 weeks • 1 SQ of 50 mg in a blinded fashion every week for 12 weeks
Endpoints- Efficacy • Change in DAS(CRP)28 score from baseline to week 12 • Proportion of subjects achieving each separately at week 12 -DAS(CRP)28 value < or = 3.2 (low disease activity) -DAS(CRP)28 value < 2.6 (remission)
Where to begin? Review Protocol and Schedule of Events Assess feasibility of protocol (staffing, resources, can CTRU accommodate?) SPCTRM website: http://med.stanford.edu/spctrm/ Clinical & Translational Research Planning (CTRP) Workbooks:
Demo of CTRP workbook • Clinical & Translational Research Planning (CTRP) Workbooks: • Identify Research Tests/Procedures and Service Codes • Estimate Staff Effort (PI/Co-PI, CRC) • Work w/ your assigned RPM on finalizing budget
IRB http://humansubjects.stanford.edu/research/medical/medical.html • RMG/Budget Specialist: Who is your RPM? “Sponsored” (Industry, NIH, Foundation) Research Only: http://med.stanford.edu/rmg/rpmmaster.html • OSR/Contracts Officers by Dept: http://ora.stanford.edu/supporting_files/osr_med_shortlist.xls
CTRU-Clinical & Translational Research Unit (formerly known as GCRC)- • http://sccter.stanford.edu/programs/ctru.html • http://med.stanford.edu/gcrc/
CTRU (cont’d) • Protocol Application Information & Fees - http://med.stanford.edu/gcrc/invest/apply.html • Stanford GCRC Laboratory - http://gcrclab.stanford.edu/
Research Pharmacy-Investigational Drug Services (IDS) • Protocol • Investigational Brochure • Set up & Dispensing Fees
Ancillary Services SHC/LPCH Clinical Laboratory • SHC/LPCH Clinical Labs Study Protocol Form- • http://spctrm.stanford.edu/secure/study_forms/Study%20Protocol%20Form%2003.20.07%20doc2.doc
IRB approved/Budget finalized • CTRP workbook (RPS & Routine Care forms finalized) • Complete Study Account Request Form (98 account) • Requires PTA# from dept finance person • Email entire CTRP workbook to PFS • PFS will email workbook back to you password protected
Begin enrolling study pts • Complete Study Enrollment Form with study pt info PRIOR to obtaining any services from the hospital • Indicates to PFS that your pt is a part of your study • If not completed in a timely manner-pt insurance will be billed & weekly report will not include your pt’s study charges
Case Study II-Industry Sponsored • Phase III • Duration of study: 24 months • Primary Objective: compare the efficacy of 2 therapeutic regimens of “X” 800 mg TID PO in combo w/ 1.5 “P” SC & weigh based dosing of “R” PO to therapy in previously untreated adult subjects w/ chronic Hepatitis C
Case Study II (cont’d) • Subjects > or = 18 years of age • Subjects will be randomized in the three treatment arms in a 1:1:1 ratio by IVRS • All subjects will initiate therapy with 4 weeks of “P” + “R” treatment (“lead-in period”).
Case Study II (cont’d) • After the 4 week lead-in period, “X” or placebo will be added, based upon arm to which the subject is randomized. • At the end of treatment all subjects will enter follow-up, whose length will vary depending on the arm to which they were randomized.
Schedule of Events • Screening Evaluations: IC, I/E criteria, VS, Demo, MH, PE, AEs, Con Meds, Liver Biopsy, Ultrasound, Chest X-ray (PA/LAT), 12 Lead ECG, Ocular Exam
Lab Evaluations • Hematology, PT/PTT, AFP, ANA, Blood Chemistry, TSH, Serum Pregnancy, HCV-RNA PCR/HCV Genotype, Urine Drug Screen • CTRP workbook -drop-down list • Lab Test Directory: http://www.stanfordlab.com/LabTestGuide/search.aspx
Treatment Visit Schedule • Clinical Evaluations: I/E, VS, PE, AEs, Con Meds, Call IVRS, Study Med Dispensing & Drug Accountability, Dosing Diary Review, Subject Telephone Contact • Lab Evaluations: Hematology, PT/PTT, Blood Chemistry, TSH, Serum/Urine Pregnancy, HCV-RNA PCR/HCV Sequence Analysis, Urine Drug Screen
Tx visit schedule (cont’d) • Other Evaluations: (optional) Pharmacogenomics/Interferon Response Assay ICF, Interferon Response Assay Sample, Pharmacogenomics Sample, Health Status Evaluation Questionnaire
Follow-up Visit Schedule • Clinical Evaluations: VS, PE, AEs, Con Meds • Lab Evaluations: Hematology, PT/PTT, Blood Chemistry, TSH, Serum Pregnancy, HCV-RNA PCR/HCV Sequence Analysis, Urine Drug Screen • Other Evaluations: Health Status Evaluation Questionnaire
Next Steps: • Complete CTRP workbook (RPS & Routine Care Forms) • Work w/ your CT RPM on finalizing tests/procedures & service codes • IRB/Budget/Contract Finalized; NOA issued • Obtain PTA# from dept finance person • Complete Study Account Request Form • Send workbook to PFS
Next Steps (cont’d) • Obtain 98 account from PFS • Update workbook (Study Enrollment Form) PRIOR to study pt acquiring any study related tests/procedures from the hospital • Review Weekly Reports (hospital & pro fees) • Make any corrections and return to PFS
Points to Consider • CTRP workbook is a requirement to begin budgeting process for ANY clinical research involving patient care (incl. obtaining research pricing REGARDLESS of funding source) • Completing the CTRP workbook (ALL info on all tabs) is a requirement to obtain a 98 and/or LPCH research account
Points to Consider (cont’d) • Need to itemize all tests/procedures incl. service/cpt codes on RPS form in order to charge to a research account • Need to obtain PTA# from dept finance person in order to initiate 98 account • Need to complete Study Enrollment Form or else your patient/insurance will be billed
Points to Consider (cont’d) • Completing the study enrollment form ensures your research pt charges will show up on weekly billing reports • 2 separate weekly reports 1) hospital and 2) pro fees only • Other Study Forms may apply-check SPCTRM website under Study Forms
Questions/Answers? SPCTRM clinicaltrials@med.stanford.edu X 8-7425 Anna Hu, RN, MPH anna.hu@stanford.edu X 8-7921