Trial Participation Hampered by Costs

September 2010, Vol 1, No 4

Cost-related factors are a chief reason for patients declining to participate in a clinical trial, a survey of 4 community oncology practices showed. Overall, 28% of patients cited cost as a factor in their refusal to participate in clinical trials, and 12% said cost was the primary reason for not participating.

“Cost is an issue,” Douglas Weckstein, MD, of New Hampshire Oncology-Hematology in Hooksett, concluded during a poster presentation at the American Society of Clinical Oncology meeting.

Some patients reported that they did not have health insurance and others said they cover the cost of copayments or deductibles. In some cases, insurers refused to cover treatment provided through a clinical trial.

The findings came from a survey of patients and physicians at 4 community cancer clinics in New England. The primary objective was to determine the proportion of patients who decline to participate in clinical trials because of costs associated with participation. Secondary objectives were to identify other reasons for not participating and to determine how often physicians at the clinics do not discuss clinical trial opportunities with patients.

A total of 213 trial-eligible patients at the 4 clinics did not participate in clinical trials. Aside from the cost factor, of the 120 patients who cited specific reasons, 50% expressed concern about possible side effects, 44% cited concern about randomization, and 33% said they were too overwhelmed and did not have the time.

Survey responses from Dr Weckstein’s clinic also showed that 40% of trial-eligible patients did not recall their physicians telling them about clinical trial opportunities.

According to Dr Weckstein, 3 potential actions could mitigate financial barriers to patients’ participation in clinical trials:

  • Legislation to cover quality trials, including coverage for deductibles and copays
  • Consideration of costly testing in trial design
  • Public funding for patient costs to participate in trials.

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