FAIR Health Data Advance Clinical Trials

January 18, 2024

As FAIR Health continues to expand and deepen our data collection, now including over 44 billion commercial claim records, opportunities for new studies abound. One use for the data is to inform stakeholders as they design and budget for clinical trials. A contract research organization (CRO) that specializes in conducting clinical trials for pharmaceutical companies and others engaged FAIR Health for benchmark pricing data and custom reports drawn from the rich, comprehensive collection of commercial claims housed in our FAIR Health National Private Insurance Claims (FH NPIC®) repository.

FH® Benchmarks and FH® Online Can Be Used for Clinical Trial Budgeting
The CRO utilized FH Online, which provides easy online access to data contained in FH Benchmarks for over 15,000 CPT®,1 CDT®2 and HCPCS codes in 493 distinct geographic areas across the United States. The company used costs for specific services, such as lab tests, blood draws, physical exams, radiology and other diagnostic tests, to calculate expenditures per patient and to plan the overall participant budget needed to complete the trial.

With access to FH Online, clients can also estimate possible extra costs, such as those for surgery (e.g., biopsy) or adverse reactions to the trial therapeutic, allowing them to create a financial plan that includes both expected and hypothetical scenarios.

FH® Custom Analytics Can Aid Clinical Trial Recruitment
Another way that FAIR Health data can advance clinical trials is by using custom analytics to aid recruitment. FH Custom Analytics make it possible to view and organize data in countless ways to meet a wide array of business needs. For example, FAIR Health’s longitudinal dataset can show the number of de-identified patients in a geographic area, by condition, age, gender and past procedures. Clients can discover the number of people in the dataset receiving a specific service, the number of people with a specific disease diagnosis, the types of services patients receive and the types of physicians they see. Providers who care for a population of patients who may be eligible for a specific clinical trial can share information with that population and assess their interest in participation.

Beyond the Clinical Trial
In addition, FAIR Health’s longitudinal dataset allows us to track de-identified patients over time. In so doing, the FAIR Health data team can contribute to market sizing by estimating total demand for services in specific geographic areas. The dataset can be used to determine not only the services received but also how far patients typically traveled for such services.

FAIR Health’s Repository Can Track Claims-Based Quality Outcomes
After a clinical service has been rendered, the FAIR Health longitudinal database can capture claims-based outcomes, such as readmission and complication rates, as well as other claims-based quality measures. These can be used to understand de-identified patients’ progress after a specific service or intervention and can also be used to better understand patient adherence to specified treatments and follow-ups. Patients can be tracked for lack of procedures and services following a specified treatment for as long as those patients remain with the same insurance plan. Patient outcomes after receiving drugs administered through injection, infusion or other non-oral means that are identified in medical billing by J codes can also be followed in the FAIR Health database.

FAIR Health’s Repository Can Contribute to Real-World Data
FAIR Health data can also be used to conduct real-world studies. For example, the FH NPIC repository was used to determine the outcomes of patients given a monoclonal antibody drug to combat COVID-19. The database was used to determine rates of COVID-19 hospitalization and mortality in those treated with the drug versus those not treated with it and the resulting study provided up-to-date effectiveness data during the Delta and Omicron waves of the pandemic. Read the study here.

Another licensee used FAIR Health data in connection with evaluating demand for a new clinic for paracentesis, a procedure to drain fluid from the abdomen. In this instance, the client believed patients in need of paracentesis were often visiting the ER to get the procedure due to a lack of available office facilities. FAIR Health data were used to illustrate the demand by showing how many patients in the specific market utilized the procedure.

FAIR Health President Robin Gelburd stated: “FAIR Health’s extensive and ever-expanding database has myriad applications. We are thrilled to offer interested stakeholders options that will aid them in advancing clinical goals, including clinical trial preparation.”

For more information on FAIR Health’s data repository and its uses, contact us by email at info@fairhealth.org or call us at 855-301-FAIR (3247), Monday through Friday, 9 am to 6 pm ET.

1 CPT © 2023 American Medical Association (AMA). All rights reserved.
2 Current Dental Terminology © American Dental Association. All rights reserved.