Costs deter low-income patients from participating in clinical trials

Low-income people diagnosed with cancer are a third less likely to be part of a clinical trial that than patients with an income of at least $50,000, according to a new study published JAMA.

Clinical trials are an essential component of medical research, yet only a fraction of eligible patients participate in them, the study found. A significant contributor to the failure of a clinical trial is inadequate numbers of enrollees, according to Joseph Unger, PhD, a biostatician and health services researcher in cancer clinical trials at the Fred Hutchinson Cancer Research Center in Seattle.

Dr. Unger and some of his colleagues studied the association between income and the rate of clinical trial participation among 1,262 patients at eight cancer clinics in the first eight months following their initial diagnosis or recurrence of breast, colorectal or lung cancer. They found 17 percent of those whose household incomes were $50,000 or higher took part in clinical trials, while 12 percent of those with lower incomes participated in clinical trials.

Clinical trials often cover the cost of the experimental treatment or procedure, but there are usually other additional costs involved. Most health plans and Medicare are required to cover routine costs, such as those for drugs, procedures and services typically paid for by insurers. However, patients may be responsible for copayments or coinsurance for those drugs and services, as well as travel and lost wages, which is a likely barrier for low-income people.

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