Insurers agree to cover clinical trial patients
Insurance companies will have to continue routine coverage for cancer patients who participate in clinical trials, under a new state agreement.
BY SHANNON COLAVECCHIO
Herald/Times Tallahassee Bureau
TALLAHASSEE — State Sen. Don Gaetz and Senate President Jeff Atwater signed a compact Wednesday that guarantees major insurers will continue to cover routine care for cancer-stricken Floridians participating in clinical trials.
The senators emphasized that the agreement will improve the development of future cancer drugs and save countless lives in Florida, where cancer is the No. 2 cause of death just as it is across the nation.
Gaetz, chairman of the Senate’s health regulation committee, negotiated the deal with health insurance companies including Humana, Blue Cross Blue Shield of Florida, Aetna, Cigna, United Healthcare, AvMed Health Plans and Vista Healthplans.
The companies are responsible for about 90 percent of Florida’s group insurance market. Also supporting the deal are medical and consumer health groups including Moffitt Cancer Center, the American Cancer Society and the Florida Medical Association.
“Nearly every Floridian has seen the struggles and the pains and the cost of cancer,” said Atwater, R-North Palm Beach, during a news conference attended by lawmakers and insurance and medical industry representatives.
“Individuals suffering and fighting cancer should not have the added stress of wondering whether their insurance will cover their care.”
Florida is the fifth state to reach an agreement covering trials, and Gaetz stressed that the compact signed Wednesday won’t cost taxpayers or result in higher premiums for the insured.
The voluntary compact includes “routine care” coverage for patients in phase II, III and IV cancer clinical trials that are approved by the National Institutes of Health, National Cancer Institute, FDA, Department of Defense or accredited Florida medical schools and specialty hospitals.
The cost of investigational drugs and therapies are typically covered by drug companies or research institutions engaged in the trials.
But traditionally, insurers refuse to cover trial participants’ routine care — such as doctor visits, lab tests and X-rays — in part because of concerns over liability, in part because they worry about higher costs for the insurers themselves.
That drop in routine care coverage discourages cancer patients from joining the trials, according to the National Cancer Institute.
And without real patient participation, new drugs and therapies cannot be developed, the Institute says.
“These clinical trials are so important,” Gaetz said. “Clinical trials open the door to the next generation of cancer treatments benefiting generations of patients for years ahead.”
Shannon Colavecchio can be reached at firstname.lastname@example.org