Where Cancer Patients are in Short Supply
There are more than 6,500 cancer clinical trials seeking adult patients… More than one trial in five sponsored by the National Cancer Institute failed to enroll a single subject, and only half reached the minimum needed for a meaningful result.
The Internet is a great recruitment tool for clinical trials. In the past, most test subjects (i.e. patients) were recruited and referred by doctors. Now many patients refer themselves and sign up online. The fact that there’s a shortage may be due to increased volume of clinical trials. But one point should not be overlooked. Study participants who are willing tend to be the ones who have exhausted all other options under current treatments.
Question: In all those cases where there are not enough enrollees to get a meaningful result, is the government paying for the trial anyway?
Another problem is that people who are mortally ill and have exhausted existing standard of care treatments often don’t have much desire to be enrolled in a trial where there is an even chance that they will be denied the experimental treatment they seek. Especially if they can get the experimental treatment by paying cash for it.
Randomized trials, a key component of comparative effectiveness research/evidence-based medicine and ObamaCare utilization controls, have their place. They are not well suited as guidelines for running a medical system that depends on innovation to meet goals of curing the sick or easing their suffering.
I believe the bigger problem is that doctors lose financially when they enroll their patients in clinical trials. Once the patient enrolls, the doctor ceases getting paid by the insurance company. The insurance company also loses since they are often expected to pay the extra costs of the trial. This is just one more example of how screwed up our third party payment system is.