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, New Orleans.
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.