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The Cancer Letter – Medicaid should pay for patients to enroll in clinical trials, coalition tells Congress

The Cancer Letter – Medicaid should pay for patients to enroll in clinical trials, coalition tells Congress

The bill, H.R. 913, was introduced in the House of Representatives by Rep. Ben Ray Lujan (D-NM) and Rep. Gus Bilirakis (R-FL).

“Clinical trials have tremendous potential to help patients with life-threatening illnesses, and for patients with cancer, clinical trials of ten of fer the best available treatment option,” Howard A. Burris, president of American Society of
Clinical Oncology, said in a statement. “It is imperative that every patient, regardless of how they are insured, have access to clinical trials.”


On July 10, the coalition—including ASCO, Friends of Cancer Research, the Association of American Cancer Institutes, the National Comprehensive Cancer Network, and the American Cancer Society Cancer Action Network—organized a “Day of Action” to lobby Congress.

“Lack of participation in clinical trials from the Medicaid population means these patients are being excluded from potentially life-saving trials and are not reflected in the outcome of the clinical research,” the coalition wrote in a Feb.
15 letter that endorses the legislation. “Increased access to clinical trial participation for Medicaid enrollees helps ensure medical research results more accurately capture and reflect the populations of this country.”


The full list of signatories to the letter is posted here.

Nearly 20% of Americans receive their health insurance coverage through Medicaid. However, unlike Medicare and private and commercial payers, Medicaid is the only major payer that is not required by federal law to cover routine costs associated with participation in clinical trials.

These routine care costs include regular doctor’s appointments, hospital stays, lab tests, drugs to manage side ef fects, and imaging. Only 11 states and the District of Columbia require Medicaid coverage for clinical trials: Alaska, California, Indiana, Iowa, Maryland, Montana, North Carolina, Texas, Vermont, and West Virginia.

A September 2018 policy statement by ASCO, “Addressing Financial Barriers to Patient Participation in Clinical Trials,” outlines a series of recommendations to address financial barriers that keep Medicaid beneficiaries from accessing
clinical trials.

Trial sponsors already pay for the experimental treatments and this bill would ensure Medicaid covers the day-to-day costs that would be incurred regardless of whether the patient is enrolled in a trial, Lisa Lacasse, American Cancer Society Cancer Action Network president, said in a statement.

“Without this legislation, Medicaid patients who join a trial can be denied coverage all together, creating a major barrier to participating in a clinical trial,” Lacasse said. “Congress should act now to address this significant barrier to medical progress and provide equal access to clinical research.”

This legislation is a step toward advancing the American Medical Association’s mission of reducing disparities and increasing health equity to improve the health of all populations, AMA president Patrice A. Harris said in a statement.

“This legislation takes aim at a Medicaid regulation that disproportionately af fects communities of color and underserved populations,” Harris said. “We commend the bill’s sponsors for recognizing this health equity issue in the Medicaid program and look forward to the legislation becoming law.”