New Faculty Orientation August 22, 2012 UAMS Research Support Center Director: Tom Wells (501) 603-1638 wellsthomasg@uams.edu Research Support Center • Lawrence E. Cornett, PhD, Vice Chancellor for Research • Tom Wells, MD, MBA, Director • Carole Hamon, BS, Associate Director • Julia Washam, RN, Associate Director Research Support Center Services • • • • • • Protocol development and review Regulatory review and support (FDA) Quality assurance (GMP, GLP) Monitoring, DSMP, DSMB Clinical trials registration Budget review and assistance with budget development • Medicare coverage analysis • Contract review, negotiation, and approval Three Topics to Consider When Planning Your Research • Research vs. the practice of medicine • Coverage analysis for tests and procedures in research studies • Clinical trial registration Clinical Research vs. Practice of Medicine • FDA does not regulate the practice of medicine • Arkansas State Medical Board does not regulate clinical research • For clinical care, physicians may prescribe “off-label” any approved drug, biological, or medical device • Approved drugs used in a new population or for a new indication may require an IND if used in research • Unapproved drugs and biologicals used in research require an IND or an exemption • Unapproved devices used in clinical research require an IDE or other clearance from the FDA Coverage Analysis • Coverage analysis is a determination, based on CMS rules, as to whether or not services that are normally billable to patients can be charged to subjects enrolled in a research study. • Third party payors may or may not pay for services that are provided as part of a research study even if those same services would be billable as part of routine care if the subject was not a research participant. • At UAMS, all research studies that include medical procedures, drugs, clinic visits, or laboratory studies must undergo coverage analysis. Public Law 110-85 Sec.801 Expanded Clinical Trial Registry • Enacted on September 27, 2007 • Requires Trial Registration (Dec 2007) – Phase II-IV drug and device trials for all diseases – Data elements: ClinicalTrials.gov + WHO/ICMJE • Requires Results Reporting (Sept 2008) – Trials of FDA-approved or cleared drugs and devices – “Basic” Results: Baseline Characteristics, Primary & Secondary Outcomes, Statistical Analyses – Adverse Events (Sept 2009) – “Expansion” of results by rulemaking (Sept 2010) • Added enforcement provisions Zarin DA, NLM Presentation, October 2009 7 Enforcement Provisions • Notices of non-compliances • Civil monetary penalties up to $10,000/day • Withholding of NIH grant funds Zarin DA, NLM Presentation, October 2009 ICMJE Policy • Editorial 2004 and updates • Registration required for manuscript consideration for following: – Interventional studies – Any phase – Any intervention • ClinicalTrials.gov or WHO Primary registry • Registration prior to enrollment first participant Zarin DA, NLM Presentation, October 2009 9 Clinical Trials Registration at UAMS • The sponsor is required to register the trial – Industry-sponsored and cooperative group trials will be registered by outside entities (sponsors) – Investigator-initiated trials meeting the above criteria must be registered by UAMS (and the PI) – RSC will help with registration • If not registered properly, you may not be able to publish your data Final Thoughts • Contact us if you are going to conduct investigator-initiated research • Research is NOT the practice of medicine; the regulatory requirements are different • We are not the Institutional Review Board nor are we Research Compliance • We are here to assist you in getting your research up and running correctly Questions? Research Support Center http//:www.uams.edu/rsc Office: (501) 526-6876