MARINA DEL REY, Calif--Clinical researchers must develop strategies
to cope with the various obstacles faced by patients and physicians
who want to participate in research trials, said oncologists at
the Association of Community Cancer Centers (ACCC) economics conference.
Because most health insurance plans generally prohibit members
from participating in trials, the number of patients enrolled
in studies has declined dramatically in recent years.
Unfortunately, it is axiomatic in clinical trials management that
"clinical trials are rarely self-supporting," said Carl
G. Kardinal, MD, associate director, Ochsner Cancer Institute,
When institutions were profitable, they were willing to make up
the costs, so they could attain the Community Clinical Oncology
Program (CCOP) designation, Dr. Kardinal said.
But with managed care, funds are drying up. Research personnel
are viewed as "non-revenue-generating," he said and
may become the "silent casualties" of cost-cutting efforts.
Cary A. Presant, MD, president, California Cancer Medical Center,
West Covina, noted that in California the problem of accrual has
become so severe that the number of CCOPs in the state has dropped
from 7 to 3--and one of those is at Kaiser Permanente (an HMO).
Through his experiences in southern California, Dr. Presant has
observed several reasons for the increasing difficulty in accruing
patients for clinical trials.