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Study Finds that Low-income Cancer Patients May Find Clinical Trials Cost-prohibitive

Only a small percentage of cancer patients participate in clinical drug trials, to the chagrin of cancer researchers. Reasons for not participating include lack of a local trial site, not meeting trial eligibility requirements, or simply not knowing that trials are going on. A recent study in JAMA Oncology adds low income to the list.

The study examined 1,262 cancer patients at eight cancer clinics over a six-month period to look at a possible link between income and clinical trial participation. The researchers found that 17% of patients with incomes above $50,000 participated in clinical trials, while 13% who earned between $20,000 and $49,999 and only 11% who earned $20,000 and below participated.

The reasons the lower-income patients did not participate included difficulty in arranging for time off work, childcare, transportation to and from the clinical trial sites, and covering copays for drugs – issues that may be easier for higher-income patients to handle.

“Since clinical trial treatments represent the newest available treatments, access to this vital resource should be available to individuals of all income levels,” the study authors wrote. One possible solution is to reimburse trial participants for costs incurred in travel or insurance copays, though there has been controversy in the past over whether that sort of compensation could potentially pressure patients into participating in a clinical trial they otherwise would not agree to. The question of whether IRBs should approve subject compensation, and the effects that lack of trial participation can have on long-term cancer trial data, will be explored in an interview with lead study author Joseph M. Unger, PhD, in the December issue of IRB Advisor.