All patients with cancer deserve a fair shot at survival, and this includes access to clinical trials. At present, however, access to these trials is restricted under Medicaid coverage, necessitating a need for change at the federal policy level, noted Fumiko Chino, MD, assistant attending radiation oncologist at Memorial Sloan Kettering Cancer Center in New York, in an interview for ASCO20 Virtual, this year’s annual meeting of the American Society of Clinical Oncology.
ASCO president Howard "Skip" Burris stated that clinical trials need to be taken to patients and that the vast majority of patients are seen in a community setting. In light of the ongoing COVID-19 pandemic, how will additional studies to improve upon your results be carried out? What improvements need to be made?
I think in terms of clinical trial access, I agree 100% with Dr. Burris. What we've done thus far is really just not enough. So, for example, unlike with other types of insurance, Medicaid sadly does not guarantee access to clinical trials for patients at the highest need. And this has been one of the policy initiatives from ASCO since 2014: to actually change the federal law to require states to cover clinical trials through Medicaid. So sadly, as it stands, those patients with cancer who are able to get Medicaid through the Affordable Care Act may still be locked out from the latest, most innovative treatments available only through clinical trials.
So this is just one example of how we need to continue to think of how health policy can really improve cancer outcomes for all Americans. And I think specifically the COVID-19 pandemic is showing to the wider public, unfortunately, what many of us in cancer care kind of already knew, that there were large health care disparities in the United States and the pandemic is proportionately impacting and killing, for example, people of color or people of lower socioeconomic status. So it's really vital to improve access to health care so that everyone has a fair shot of surviving. Specifically in cancer care, our study shows that improved access to health insurance can really translate to improve cancer survival.