People on Medicaid and uninsured are less likely to benefit from clinical trials of new treatments if they have cancer, a new study has found. File Photo by TBIT
April 30 (UPI) -- Cancer patients on Medicaid or who don't have insurance benefit less from experimental treatments, even if they get into clinical trials, a study published Thursday by JAMA Network Open has found.
Medicaid beneficiaries or those who have no health insurance are only 23 percent more likely to achieve added survival from an experimental treatment, according to researchers at the SWOG Cancer Research Network, Fred Hutchinson Cancer Research Center and Columbia University Medical Center.
People with private health insurance, however, are 66 percent more likely to derive added survival from interventions still under investigation.
The findings suggest that the uninsured and those on Medicaid effectively might be excluded from clinical trials -- because the costs aren't reimbursed -- and therefore don't have access to the potentially beneficial approaches being investigated.
"In the trials included in this study, patients were offered the best standard treatment for the cancer or an experimental treatment thought to be at least as good as the standard treatment and perhaps better," study co-author Dr. Joseph M. Unger, a biostatistician and health services researcher at Fred Hutchinson Cancer Research Center in Seattle, told UPI.
"The best standard treatment represents what is routinely administered to patients in clinical practice who are not in trials but the expected benefits of experimental treatments are not experienced by all patients, especially those with no insurance or Medicaid," Unger said.
Some 1.8 million Americans will be diagnosed with cancer this year, according to the U.S. National Cancer Institute. More than 74 million Americans are enrolled in Medicaid and, while exact figures on cancer prevalence among program beneficiaries are unknown, the Cancer Action Network estimates that 1 in 3 children diagnosed with cancer in the United States are enrolled at the time of diagnosis.
For the study, researchers focused on Phase 3 clinical trials of new cancer therapies conducted since 1985 under the auspices of the SWOG Cancer Research Network. They reviewed data from 19 clinical trials on nearly 11,000 participants.
All of the trials included in the analysis yielded positive results, based on added overall and progression-free survival, for the treatments being investigated.
The findings highlight the potential benefits of these new approaches in many people with cancer and the importance of insuring that all patients have access to these innovations, regardless of insurance status, the authors noted.
"This study highlights how policies related to insurance coverage are critical for the health of patients with cancer," Unger said.
"In particular, they provide support for an important piece of legislation currently before Congress that seeks to require state Medicaid programs to cover the routine patient costs of cancer clinical trial participation."