Wausau, WI | Clinical Trials Hidden Gems

Wausau-Stevens Point, WI

A Gem in the Heart of Wisconsin

Written by Jack Beecher, TrialScout Data Analyst

One area of interest in this analysis is the Wausau-Stevens Point-Wisconsin Rapids, Wisconsin Combined Statistical Area (CSA), an area in the heart of the state roughly 3 hours northwest of Milwaukee. This CSA has a population just over 200,000 and an overall total of 2,375 clinical trials conducted over the past 20 years, ultimately creating an index value of 11.5 clinical trials conducted per 1,000 residents1,5. This value places Wausau second among all CSAs in the country. The only CSA to rank higher than Wausau-Stevens Point-Wisconsin Rapids in this regard is the Rochester-Austin, Minnesota CSA, which is the home of the Mayo Clinic. Of the trials conducted in the area, about 60% are currently active and slightly more than 20% are currently recruiting for participation1

According to the U.S. Office of Management and Budget, the Wausau CSA encompasses Marathon, Lincoln, Portage, and Wood counties in Wisconsin. This area houses the towns of Wisconsin Rapids, Marshfield, Wausau, Weston, and Stevens Point among others3. According to Emsi’s (a labor and economics aggregation website) overview of central Wisconsin, the general area’s largest industries include manufacturing, government, and retail trade, all of which are above the national average for number of jobs. Manufacturing and management are the top growing industries in the area, while agriculture is nearly three times as concentrated within the area as the national average. Notably, however, is the fact that the healthcare industry is the second largest in the area for total jobs, potentially underlying the high clinical trial performance of the greater Wausau area2

A breakdown of the active clinical trial performance per year of health systems within the greater Wausau area is shown below1:

Active Trial Performance of Health Systems in Wausau CSA

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As you can see, the Marshfield Clinic Health System is by far the most active in the Wausau CSA for clinical trials; it has conducted 65.4% of all clinical trials in the area1. Thus, the efforts of the Marshfield Clinic serve as the primary reason the Wausau CSA is elevated to “Hidden Gem” status in the clinical trial industry. 

The Marshfield Clinic was originally founded in 1916 in Marshfield, a town described by Chief Administrative Officer Scott Polenz as “an anomaly”; a rural town with a high concentration of healthcare professionals4. This creates an interesting link: an atypical area for healthcare in general is also one for clinical trials. Today, the Marshfield Clinic has over 50 locations across the entire state of Wisconsin, including four hospitals, but is primarily clinic-based4,6. The health system established its Research Institute 43 years after it was founded, which currently has seven different research programs that are active across Marshfield Clinic locations7,8. The year-by-year active trial totals for the six Marshfield Clinic locations in the Wausau CSA that are conducting clinical trials can be seen below. This is accompanied by the totals for The Diagnostic and Treatment Center in Weston, which is the top alternative clinical trial site in the Wausau CSA1

Active Trial Performance of Marshfield Clinic Locations in Wausau CSA

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The general trend for these locations is one of steady growth each year in active trial output. The complete opposite is seen for the Marshfield Medical Center’s Cancer Center, however; it has steadily decreased overall. In total, the combined active trial output of Wausau’s Marshfield Clinic locations just about doubled over the past decade. The Diagnostic and Treatment Center grew significantly between 2008 and 2011, as well as 2012 and 2014, but saw a decrease in between these two periods and has seemingly steadied since 2014. The distribution and status of currently active clinical trials at the locations in the above graph are shown here1:

Marshfield Clinic Clinical Trials in Wausau, WI CSA

Copyright © 2019 TrialScoutTM

These sites generally have a greater portion of active trials that are not recruiting than those that are recruiting, but the Marshfield Clinic’s Stevens Point Center bucks the trend.

 *The following analyses are based on a normalized scale rather than raw count of clinical trials. As a result of low active trial volume, the data for the Marshfield Medical Center Cancer Center is skewed from the averages and totals of other featured locations on the metrics explored and is thus not included.* 

The Marshfield Clinic’s clinical trials in the greater Wausau area are predominantly Phase 2 and Phase 3 trials; roughly half of its currently active trials are Phase 3 while one-third of them are Phase 2. This general pattern holds true when looking at all currently active trials in the Wausau CSA, not just those belonging to the Marshfield Clinic. The distribution of active clinical trials by phase at the Marshfield Clinic’s locations in the Wausau CSA is displayed below, compared to the distributions of active trials by phase for the entire health system as well as the whole country for reference. The Diagnostic and Treatment Center is also displayed1.

Phase of Active Trials Conducted at Marshfield Clinic Locations in Wausau CSA

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The Marshfield Clinic’s Wausau locations are generally in line with the health system and national averages, but there is some variance. The Marshfield Medical Center has a somewhat smaller contingent of active Phase 2 trials when compared to the rest of the health system, while the health system as a whole is below the national average for “other.” In addition, the Marshfield Clinic is well below the national average for Phase 1 trials. In general, however, the Marshfield Clinic locations in Wausau exceed the national average for Phase 2 and Phase 3 trials, and The Diagnostic and Treatment Center appears to follow a similar pattern1.

In addition to a large contingent of Phase 2 and 3 clinical trials, the Marshfield Clinic also has a heavy focus on drug trials in the Wausau CSA. A chart displaying the intervention types of the currently active trials in Wausau is displayed below1. It is important to note that a single clinical trial can be labeled with multiple intervention types.

Intervention Type of Active Trials in Wausau CSA

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Of the Marshfield Clinic Health System’s active clinical trials in the greater Wausau area, more than three quarters are labeled as drug trials, roughly 65% are classified as “other,” about 40% are biological treatments, while 13% involve procedures and another 13% involving radiation. The Marshfield Clinic’s Wausau locations have very similar distributions to those of the entire health system. As a collective whole, these locations have slightly higher concentrations of drug, radiation, and procedure trials than the national average while boasting significantly higher concentrations of biological and “other” trials. Notably, the Diagnostic and Treatment Center has higher concentrations of drug, biological, radiation, procedure, and “other” trials compared to the national average as well. These trends generally apply to the Wausau CSA as a whole when comparing it to the national average; however, another common trend is that the Wausau CSA and its constituent clinical trial locations are well below the national average for device and behavioral trials1

The currently active clinical trials in the Wausau CSA are predominantly sponsored by a category labeled as “other,” which usually refers to physician-, health system-, or research group-initiation. Roughly 57% of Wausau’s active trials have a lead sponsor of this type, while about 39% list a National Institutes of Health (NIH) subsidiary as the lead sponsor. Going further, each instance of NIH sponsorship is the Wausau CSA is attributable to the National Cancer Institute (NCI). The remaining 4% is industry-sponsored (usually referring to a pharmaceutical company). The distributions by sponsor for the Marshfield Clinic locations in the greater Wausau area, as well as The Diagnostic and Treatment Center, are found in the graph below1:

Lead Sponsor of Active Trials Conducted at Marshfield Clinic Locations in Wausau CSA

Copyright © 2019 TrialScoutTM

The Marshfield Clinic Health System predominantly conducts “other”-sponsored trials while being apparently underutilized by industry, and its Wausau locations are no exception to this trend. In fact, the only Marshfield Clinic trials that have a lead industry sponsor are at the Marshfield Medical Center. These locations are generally well above the national average for concentrations of NIH-sponsored and “other”-sponsored trials, but are also well below the national average for industry-sponsored trials.

Like it does for phase of active trials, the Diagnostic and Treatment Center follows a similar trend to the Marshfield Clinic locations in Wausau for lead sponsor1. This suggests that perhaps the Wausau area as a whole, and not just the Marshfield Clinic, is underutilized for industry-sponsored clinical trials despite having the resources to handle a heavier workload, and this appears to be the case. Again, only 4% of the currently active trials in the Wausau CSA are industry-sponsored1.

For a final analysis of the Marshfield Clinic in the Wausau CSA, a look at the conditions for which the active clinical trials the health system is conducting in the area reveals a heavy focus on cancer and blood disorders. Across the health system’s locations in the Wausau area, the five most common conditions being studied are Recurrent Squamous Cell Lung Carcinoma, Breast Cancer, Stage IV Squamous Cell Lung Carcinoma AJCC v7, HER2/Neu Negative Cancer, and Lymphoma. A list breaking down the most common conditions (in order) studied at each individual location in the area follows1:

Marshfield Medical Center

Marshfield Clinic – Weston Center

Marshfield Clinic – Wisconsin Rapids Center

Marshfield Clinic – Stevens Point Center

Marshfield Clinic – Wausau Center

Recurrent Squamous Cell Lung Carcinoma

Breast Cancer

Recurrent Squamous Cell Lung Carcinoma

Recurrent Squamous Cell Lung Carcinoma

Recurrent Squamous Cell Lung Carcinoma

Breast Cancer

Recurrent Squamous Cell Lung Carcinoma

Breast Cancer

Stage IV Squamous Cell Lung Carcinoma AJCC v7

Stage IV Squamous Cell Lung Carcinoma AJCC v7

Stage IV Squamous Cell Lung Carcinoma AJCC v7

HER2/Neu Negative Cancer

HER2/Neu Negative Cancer

Breast Cancer

Breast Cancer

Lymphoma

Stage IV Squamous Cell Lung Carcinoma AJCC v7

Stage IV Squamous Cell Lung Carcinoma AJCC v7

HER2/Neu Negative Cancer

HER2/Neu Negative Cancer

HER2/Neu Negative Cancer

Lymphoma

Estrogen Receptor Negative

Ovarian Clear Cell Adenocarcinoma

Estrogen Receptor Negative


In review, when looking at the top five conditions being studied at each Marshfield Clinic location in the Wausau CSA (except the Marshfield Clinic Medical Center Cancer Center), 23 of 25 possible combinations of location and condition feature a strong focus on oncology and blood disorder-related clinical trials. For The Diagnostic and Treatment Center, the five conditions being studied the most currently are Recurrent Squamous Cell Lung Carcinoma, Stage IV Squamous Cell Lung Carcinoma AJCC v7, Breast Cancer, Lymphoma, and Colorectal Cancer. Across the Wausau CSA as a whole, the five most commonly studied conditions and active clinical trials are for Recurrent Squamous Cell Lung Carcinoma, Stage IV Squamous Cell Lung Carcinoma AJCC v7, Breast Cancer, HER2/Neu Negative Cancer, and Lymphoma1.  

References

  1. Approximate attributable data as per the TrialScout database collapse as of 10/28/2019. All data is derived from https://clinicaltrials.gov/
  2. (2018). Economy Overview: wda6 [PDF File]. Retrieved from http://chambermaster.blob.core.windows.net/userfiles/UserFiles/chambers/2119/CMS/EconomicDevelopmentPlan/Economy_Overview366.pdf
  3. OMB Bulletin No. 18-04: Revised Delineations of Metropolitan Statistical Areas, Micropolitan Statistical Areas, and Combined Statistical Areas, and Guidance on Uses of the Delineations of These Areas” (PDF File). United States Office of Management and Budget. September 14, 2018. Retrieved August 14, 2019.
  4. Seifert, S. (2019). ‘The little engine that could’: Marshfield Clinic Health System’s new Eau Claire hospital has a plan to keep local healthcare affordable. Retrieved from https://chippewa.com/business/businessreport/the-little-engine-that-could-marshfield-clinic-health-system-s/article_7d80eab7-ed68-5760-89e4-eb2284b4de94.html
  5. S. Census Bureau, Population Division. (2019). Annual estimates of the resident population: April 1, 2010 to July 1, 2018 – United States – Combined statistical area; and for Puerto Rico. Retrieved from https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk
  6. Unknown Author. (n.d.). About Marshfield Clinic. Retrieved from https://www.marshfieldclinic.org/about-us
  7. Unknown Author. (n.d.). Marshfield Clinic Research Institute. Retrieved from https://marshfieldresearch.org/about/welcome
  8. Unknown Author. (2019). Marshfield Clinic Research Institute Fact Sheet [PDF File]. Retrieved from https://www.marshfieldresearch.org/Media/Default/Documents/21734-000_MCRI_Long.pdf