The teaching hospital and drug trials

Managing clinical trials is, for the pharmaceutical industry, a growing headache in Europe. One key to the problem: the teaching hospital, according to Karolinska Institutet President Harriet Walllberg-Henriksson.

Teaching hospitals – where research, doctor-training and healthcare all happen under the same roof – “is a niche where Europe has been very successful” in the past, says Wallberg-Henriksson. Now, however, “there is a warning flag. The number of clinical trials is going down. The number of (medical-research) citations and publications in Sweden is decreasing” in relative standing against other key European countries. The cost of conducting trials in Europe is rising.

Karolinska University Hospital is a model of how the teaching hospital can help. It has 1,600 beds, 1.4 million patient visits a year, and 2,100 researchers. Having doctors who do research, and researchers who practice medicine, often produces unexpected insights. For instance, Wallberg-Henriksson cites one Karolinska spin-out company, Cogmed, founded by a neuropaediatric specialist at the hospital who noticed that some children with attention deficit disorder seemed to respond well to video games. The upshot: the development of a new software product to help ADD children improve concentration skills. The company reported sales of €4.5 million in 2006.

Of course, it’s expensive to run a teaching hospital – but organizational problems are at least as important an obstacle as financial in maintaining a vital cross-fertilization of teaching, clinical and research cultures. For instance, Wallberg-Henriksson says, in Sweden the healthcare services of a hospital are regulated by local health authorities, whereas the research activities are funded by national grants agencies – meaning hospital researchers can get pulled in contradictory directions, in the competition for their time and talents. One possible help, she says, would be the reorganization of the research funding system so that there is one agency responsible for funding and supervision of clinical medical research.

The Swedish government has formed a task force, of which Wallberg-Henriksson is a member, to study the problem and make recommendations over the next two years.