Payers Question Their Role in Financing Clinical Research Trials

CHICAGO—A recurring theme voiced by members of the oncology community throughout a two-day conference on purchasing oncology services was the need for payers to financially support the participation of cancer patients in NCI-sanctioned clinical trials.

“Clinical trials are essential for progress and in the best interest of purchasers of oncology services because they are necessary to learn what works and what does not work,” said Paul Sperduto, MD, MPP, a radiation oncologist at Methodist Hospital Cancer Center, Minneapolis, Minn.

Some of the payers attending the American Cancer Society-sponsored conference, however, said they feel they are being unfairly chastised by providers for their reluctance to finance trials, and that many of their questions on the subject have not been adequately answered.

Although thousands of patients who are insured by Prudential Health Care, Roseland, NJ, participate in clinical trials every year, Arthur Levin, MD, the company’s vice president of Technology and Clinical Practice Assessment, is not convinced that the majority of patients want to be involved in the clinical trial process.

Dr. Levin also wondered about the process of selecting treatment topics for clinical trials. “Who decides what things are studied? Do we have faith in that process and in defining the ‘well-designed’ clinical trial?” he asked.

Purchasers are concerned about whether patients in trials receive enough information to give informed consent. “The experience I’ve had suggests that is not always the case,” Dr. Levin said.

Payers also want more data on the projected costs associated with clinical trials. “What does it cost to care for someone on a trial? How many patients are on such trials? What is the expected growth rate of that population?” Dr. Levin asked. “We feel we can insure almost anything, but we need some basic facts.”

Finally, he asked whether subscribers to health insurance plans should be compelled to fund clinical research or whether the obligation for supporting testing of new treatments should be more broadly spread out among society as a whole.

“We’re not categorically opposed to paying for clinical trials, but I do think there is an issue, because we serve as fiduciaries for the money that is entrusted to us,” he said. “That is why I think we should look at the issue of whether subscribers should be obliged to purchase insurance that covers clinical trials or whether they should have a choice.”