ASCO and other organizations submitted recommendations to the Centers for Medicare & Medicaid Services to influence development of a clinical trials coverage regulation of the Patient Protection and Affordable Care Act.
The health-care law requires insurers to cover routine care costs for patients taking part in certain clinical trials for the prevention, detection, or treatment of cancer or other life-threatening illnesses. The coverage requirement will become effective on January 1, 2014.
“The option to participate in a clinical trial is a key component of high-quality cancer care and should be a readily accessible option for any cancer patient,” said Yu-Ning Wong, MD, a medical oncologist at Fox Chase Cancer Center and member of ASCO’s Cancer Research Committee, who took a leadership role on this issue. “Congress reaffirmed the importance of clinical trials in the health-care reform law. We look forward to working with CMS to ensure that all cancer patients have access to clinical trials.”
ASCO and the other signatories recommend that CMS establish safeguards to:
- Protect individuals with cancer from delays and administrative barriers to trial participation.
- Ensure that prevention, detection, and treatment of complications arising from trials are covered as routine patient costs.
- Prevent insurers from requiring patients to travel extensive distances to enroll in a trial with an in-network provider.
- Ensure patients are informed as to whether their insurer covers the routine costs associated with participation in clinical trials.
- Prevent financial incentives arising from Accountable Care Organizations from inadvertently creating barriers to patient participation in clinical trials.
- Establish a mechanism for reporting concerns relating to the coverage of clinical trials.
In addition to ASCO, the organizations signing the recommendations were the American Association for Cancer Research, American Cancer Society Cancer Action Network, American Society for Radiation Oncology, American Society of Hematology, Association of American Cancer Institutes, Coalition of Cancer Cooperative Groups, LIVESTRONG, Lance Armstrong Foundation, National Coalition for Cancer Research, National Comprehensive Cancer Network, National Lung Cancer Partnership, Oncology Nursing Society, Pancreatic Cancer Action Network, Prevent Cancer Foundation, Research Advocacy Network, and Susan G. Komen for the Cure Advocacy Alliance. ■
© 2012. American Society of Clinical Oncology. All Rights Reserved.
