State laws mandating clinical trial reimbursement

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ASCO’s Targeted Agent and Profiling Utilization Registry (TAPUR) Study is a non-randomized clinical trial aiming to describe the performance of commercially available, targeted anticancer drugs prescribed for treatment of patients with advanced cancer with a potentially actionable genomic variant.

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To assess the number of Kansas adults aged 19–64, newly covered with health insurance for participation in oncology clinical trials as a result of the ACA, a cross sectional design using extracted data from the 2012 American Community Survey, Public Use Microdata Sample to estimate the number of individuals covered by insurance and data from the 2014 Department of Health and Human Services Health Insurance Marketplace enrollment to estimate those newly enrolled through ACA.

Three main factors limit the effectiveness of the ACA provisions in expanding clinical trial coverage: 1) ‘grandfathered’ self-funded employer plans not subject to state Employee Retirement Income Security Act (ERISA) regulations, 2) Medicaid coverage limits not addressed under the ACA, 3) populations that remain uninsured.

Participation in cancer clinical trials has been shown to increase overall survival with minimal increase in cost, but enrollment in adult cancer clinical trials remains low.

One factor limiting enrollment is lack of insurance coverage, but this barrier should be reduced under the 2010 Patient Protection and Affordable Care Act (ACA), which includes a provision requiring coverage for clinical trial participation as of 2014.

ASCO’s growing roster of cutting-edge journals serves readers as the most credible, authoritative, peer-reviewed resources for significant clinical oncology research and research that informs the delivery of efficient, high-quality cancer care across the globe.

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The information below provides resources and highlights ASCO’s policy efforts on the topic.

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The law applies to clinical trials designed to study new methods to prevent, detect, or treat cancer or another life-threatening illness.