Advanced market clinical trial design commitments

I enjoyed reading a post by Witold Więcek on the Clinical Trials Abundance blog, titled ‘Market shaping and trial design belong together’. He explains why people interested in solving market shaping problems – such as economists designing advance market commitments and philanthropists funding multiple R&D projects for global health problems – should be interested in innovative clinical trials.

Most drugs today are tested in separate clinical trials: one drug vs one placebo, which is much more inefficient than running them together in a platform trial (with, for example, five drugs vs one placebo). That structure also makes it hard to make head-to-head comparisons between different drugs, since separate trials might enrol different kinds of patients, run at different times, and measure different outcomes.

That means the standard way to run clinical trials is less useful for decision-making. A market shaper, for example, might want to specify some criteria that different drugs have to achieve in order to receive a prize or payout from an advance market commitment. But differences in trial design and setting would leave open a lot of uncertainty about which ones qualify. So, he argues, why not have them play a role in designing the trial as well?