The costs of treating cancer patients on clinical trials are not higher than the costs of standard treatment, according to a study sponsored by the Association of American Cancer Institutes (AACI) and the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. The results of the study were presented today at the annual meeting of the American Society of Clinical Oncology (ASCO), Ernest N. Morial Convention Center, New Orleans, La.
"Cancer clinical trial costs often are not reimbursed by Medicare or private insurers primarily because of concern that the costs of medical care for patients on clinical trials are much higher than the costs that are incurred for standard care in the clinical practice setting," said lead investigator Charles L. Bennett, M.D., Ph.D., associate professor of medicine, the Robert H. Lurie Comprehensive Cancer Center at Northwestern University, and director of health services research, VA Chicago Health Care System-Lakeside Division.
"Confirmation of the study's findings could result in access to the best cancer care available for patients who previously would have been denied," added Dr. Bennett.
The AACI/Northwestern-sponsored project evaluated the total direct medical charges for six months of care for 70 cancer patients at five AACI member cancer centers. Thirty-five patients who received care on phase II cancer clinical trials were matched based on age, gender, type of cancer, stage of the disease and treatment period to 35 control patients who received standard care. (A phase II clinical trial tests the safety of a drug and begins to evaluate how well a new drug works, and phase II studies usually focus on a particular type of cancer.) The average age of trial patients was 58.3 years versus 53.7 years for control patients for persons with cancer of the breast (24), lung (18), colon (16), prostate (4) and lymphoma (8). Seventy-five percent of the patients had advanced cancer, stage three to stage four disease.
Charge data was obtained for hospital ancillary services from automated claims files and compared. The average charge for treatment from the time a patient enrolled in the study through six months was $57,542 for trial patients and $63,721 for control patients. The study did not consider the $6,180, or 10.7 percent, savings for trial patients to be significant except as evidence suggesting that the costs of clinical trials are not higher than costs of standard care.
"Cancer experts and advocates agree that an essential element of excellent cancer care is access to high quality clinical trials," said Ronald B. Herberman, M.D., president of the AACI and director of the University of Pittsburgh Cancer Institute (UPCI), one of the centers that participated in this study. "Due to concerns about reimbursement by insurance companies, many patients decide not to participate in clinical trials or withdraw before completion of a new therapy that may offer the best hope of improved outcome or survival."
To confirm the results of the study, investigators currently are discussing a collaboration with a recently initiated RAND/National Cancer Institute (NCI) study that would involve many more cancer centers.
In addition to UPCI and Northwestern in Chicago, AACI member institutions that participated in the study were Fox Chase Cancer Center, Philadelphia, Pa.; H. Lee Moffit Cancer Center and Research Institute, Tampa, Fla.; Jonsson Comprehensive Cancer Center/UCLA, Los Angeles, Cal.; Tulane Cancer Center, New Orleans, La.; and the University of Michigan Comprehensive Cancer Center, Ann Arbor, Mich.
The AACI is an association of the nation's leading academic and free-standing cancer centers. Of the AACI's nearly 90 members, 50 are NCI-designated centers, and the remaining members all are dedicated with varying degrees of emphasis to a broad spectrum of cancer research, education, treatment, and prevention.
Established in 1959, AACI fosters multidisciplinary and inter-institutional collaborations for the control of cancer through its large network of established cancer institutes, which represent the hubs of virtually all cancer constituencies, from researchers, to physicians, to patients and patient advocates.
A main objective of AACI is to educate the public about the unique strengths and resources of cancer centers and the important role they play in preventing and developing cures for cancer and providing the most up-to-date cutting edge cancer therapies for patients. As a representative of the nation's most prestigious centers, the Association is a leading voice on national public policy issues related to cancer, in particular, the importance of both increased funding for basic and clinical research and reimbursement for patients who participate on cancer clinical trials.
The Robert H. Lurie Comprehensive Cancer Center of Northwestern University is the focus of cancer research, education and patient care at Northwestern University. The cancer center coordinates clinical research and cancer patient care programs at the affiliated teaching hospitals of the McGaw Medical Center of Northwestern University, which include Northwestern Memorial Hospital, Children's Memorial Hospital, Evanston Northwestern Healthcare, The Rehabilitation Institute of Chicago and the Veterans Administration Lakeside Medical Center.
Note to editors: to interview Dr. Charles Bennett, please contact the ASCO press room at 504-670-7210.
CONTACT: May 21 to 23, 2000
Lauren Ward
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