How Can Financial Barriers to Patient Participation in Clinical Trials Be Addressed?

December 4, 2018

In the latest ASCO in Action Podcast, Dr. Beverly Moy, a medical oncologist at the Massachusetts General Hospital, joined ASCO CEO Dr. Clifford A. Hudis to discuss patient participation in clinical trials and how policymakers, trial sponsors, and other stakeholders can help remove and overcome financial barriers.

Dr. Moy, an associate professor of Medicine at Harvard Medical School and co-author of ASCO’s recently released policy statement on financial barriers to clinical trials, says that improving trial participation in underserved groups is incredibly important to discovering the best cancer treatment. In order to develop the best treatments, Dr. Moy stresses that clinical trials need to represent the general population affected by cancer – everyone.

“When access to the best possible experimental therapy is threatened, optimal cancer care becomes impossible due to financial barriers” she says.

During the discussion, Dr. Moy notes that older and poorer patients—those covered by Medicare and Medicaid—face greater financial burden than patients covered by private payers due to the lack of coverage of routine costs associated with clinical trials participation. These extra costs can prohibit individuals with cancer from considering or even continuing in a clinical trial. She recounts the story of one her patients—a young woman with two young children—who had high-risk breast cancer. The woman prematurely dropped out of the clinical trial because it required more frequent medical visits and blood tests due to potential toxicities and higher insurance co-pays and deductibles that she couldn’t afford. “That’s really unacceptable,” says Dr. Moy.

The podcast discussion also addressed a number of recommendations made in the ASCO policy statement, including reducing patient financial burdens that are built into clinical trials. Those designing a clinical trial should think about the extra procedures, tests, and medical visits required of participants and need to determine whether those extra steps and extra costs add value to the trial. “If they are not critical to the study, they really shouldn’t be done,” stresses Dr. Moy.

“No patient should be harmed financially because of their contributions to the advancement of science,” says Dr. Moy. “If we’re united in this belief, then we really can move forward together.”

To hear the full discussion, subscribe to the podcast through iTunes and Google Play, or listen to the episode here.