Cancer patient seeks insurance coverage for clinical trials

"The base policy that is available in states with mandates tends to cost a lot more than policies that are available in states where people can pick and choose the types of things they want covered in their benefit packages,” Ghose said.

However, Tracie Anderson, clinical operations director of the University of Oklahoma Cancer Institute, said insurance carriers have not been adversely affected in states that mandated similar coverage.

"Over 23 other states in our country already have this legislation, and the insurance industries have not opposed it,” Anderson said. "It is not precedent setting across our country in any way, and we just hope that Oklahoma is not the last state to get it passed.”

Some health plans will pay for routine medical care for patients in clinical trials that are conducted under specific guidelines set out by medical societies, Ghose said, provided that costs are shared by both the health insurers and the sponsors of the clinical trials.

"In many cases today plans will help you find appropriate clinical trials,” Ghose said.

"If you are enrolled, then the conductors of the clinical trial have a responsibility to provide some of the coverage for the testing that is involved in the pure sense of the clinical trial.”

The industry takes a cautious approach to clinical trials in terms of both safety and design, he said. Clinical trials often are based on unproven treatments or drugs.

"Are we making sure that that is absolutely the appropriate clinical trial for that person,” he said. "While meaning well, making health care into a political issue can be very difficult especially in the face of the medical science.”

Business Writer Jim Stafford