News | September 22, 2008

Medicare HMO Costs Keep Cancer Patients Out of Clinical Trials

September 23, 2008 - The number of newly-diagnosed cancer patients age 65 and older who are enrolled in Medicare’s Health Maintenance Organization (HMO) plans has increased by 6 percent within the past four years, and is shown to limit patients’ participation in clinical trials because they believe they cannot afford the plan’s out-of-pocket expense, according to a first-of-its-kind study presented at ASTRO 2008.

While nearly two-thirds of cancer patients are age 65 and older, less than one-third of patients in this age group are enrolled in clinical trials. Health insurance coverage costs have been cited by elderly patients as reasons why they don’t enroll in clinical trials. This disparity suggests it may be related to Medicare HMO payment policy, which requires additional personal expense for clinical trial participation and may vary depending on the HMO plan. Medicare reimbursement policies differ between fee-for-service (FFS) and HMO plans.

“Clinical trials are the cornerstone in finding better, more effective cancer treatments,” said Chyongchiou Lin, Ph.D., lead author of the study and an associate professor of health economics at the University of Pittsburgh Cancer Institute’s Department of Radiation Oncology in Pittsburgh. “The National Cancer Institute has made clinical trial participation a top, national priority, yet current Medicare reimbursement policies show it might be a barrier for participation by a large number of patients with Medicare HMO coverage and discourages cutting-edge treatment options for a very vulnerable population. The current policy should be re-examined to be consistent with NCI initiatives.”

The study shows that the overall proportion of newly-diagnosed cancer patients who had consultations and were insured by Medicare HMOs increased from 21 percent in 2003 to 27 percent in 2007 in five hospitals participating in the UPMC McKeesport Radiation Oncology Community Outreach Program (ROCOG), a consortium of hospitals in Western Pennsylvania, funded by the NCI’s Radiation Research Program and the Cancer Disparities Research Partnership, that focuses on improving access and outcomes for underserved populations with cancer. The research team in the lead community hospital participating in the program found in 2007 that patients eligible for innovative clinical trials opted out of enrolling in a “Medicare Qualifying” clinical trial due to the financial burden of participating.

For more information: www.astro.org

Source: American Society For Therapeutic Radiology and Oncology

Related Content

SBRT Considered Safe Treatment Option for Patients With Multiple Metastases
News | Stereotactic Body Radiation Therapy (SBRT) | November 01, 2018
The NRG Oncology clinical trial BR001 tested the hypothesis that stereotactic body radiotherapy (SBRT) could be used...
Overall survival of metastatic patients with SABR presented at ASTRO 2018. #ASTRO #ASTRO18 #ASTRO2018
News | Radiation Oncology | October 30, 2018
October 30, 2018 — In the first randomized, phase II clinical trial of its kind, researchers have shown that an aggre
Amar U. Kishan, M.D., presents data about stereotactic body radiation therapy at ASTRO 2018. #ASTRO #ASTRO18 #ASTRO2018

Amar U. Kishan, M.D., presents data about stereotactic body radiation therapy at ASTRO 2018.

Feature | Stereotactic Body Radiation Therapy (SBRT) | October 23, 2018 | By Greg Freiherr
With its shorter course of treatment,...
CyberKnife System Provides Excellent Prostate Cancer Survival Rates in Five or Fewer Sessions
News | Stereotactic Body Radiation Therapy (SBRT) | September 27, 2018
Accuray Inc. announced that published data from two prospective, multi-center studies using differing protocols provide...
First Patient Treated in Online Adaptive Radiotherapy Trial With CyberKnife System
News | Stereotactic Body Radiation Therapy (SBRT) | April 06, 2018
Accuray Inc. and Erasmus MC announced the first patient has been successfully treated using an online-adaptive (OA)...
​ITN Celebrates World Cancer Day 2018
News | Radiation Oncology | February 01, 2018
World Cancer Day takes place annually on Feb.
Age Impacts Post-treatment Mortality for Early-stage Lung Cancer Patients

Image courtesy of Henri Becquerel Cancer Center

News | Stereotactic Body Radiation Therapy (SBRT) | January 24, 2018
A University of Colorado Cancer Center study published in the Journal of Clinical Oncology explores mortality in the...
FDA Clears GammaPod Stereotactic Radiotherapy System for Breast Cancer Treatment
Technology | Stereotactic Body Radiation Therapy (SBRT) | December 22, 2017
The U.S. Food and Drug Administration (FDA) has cleared the new GammaPod noninvasive stereotactic radiotherapy system...
Elekta and Brainlab Offer Streamlined Workflow for Stereotactic Radiotherapy
News | Radiation Therapy | October 16, 2017
Elekta and Brainlab have reconfirmed their alliance for the integrated use of the Elekta Versa HD linear accelerator...