Cancer Clinical Trials: Will you get stuck with the bill?

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The answer is not simple, but often the news is favorable. It turns out that it matters where you live and how old you are.  In general, clinical trials that test treatments for cancer provide the new investigational drug free of charge and also cover those procedures that are being done solely for research purposes. Those things that routinely happen in the course of cancer care—such as physician visits, routine lab tests, and scans—are generally billed to the patient’s health insurance provider.

Many, but not all insurers cover these costs. For those over the age of 65, Medicare covers these costs for most clinical trials. The majority of states have passed laws requiring that state-regulated health plans also cover such costs and The Patient Protection and Affordable Care Act (PPACA) (a.k.a. healthcare reform law) requires that all insurers cover these costs by 2014. 

A recent study published in the Journal of Clinical Oncology reports that about half of current state laws fall short of the upcoming federal requirements.  The most common shortcomings include lack of coverage for prevention studies and phase I studies. Learn more about these issues and see where your state stands in the article.


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(c) 2012 Tom Beer and Larry Axmaker

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