Patient reimbursement in therapeutic cancer clinical trials: An 18‐year multicenter experience
Year: 2026
Type: article
Abstract: BACKGROUND: Clinical trials add to the financial burden of cancer care. To expand equitable access to trials, from 2006 to 2024 the Lazarex Cancer Foundation reimbursed nonmedical expenses related to therapeutic cancer clinical trial participation. METHODS: Eligible patients were enrolled in a cancer treatment trial and had a household income of ≤700% of the federal poverty level. Expense reimbursement occurred at 50%, 75%, and 100% according to income level. This study analyzed the type, timing, and amounts (in 2024 dollars) of reimbursed expenses for trial participants. Associations between patient/trial characteristics, reimbursed amounts, and distance traveled were evaluated via t-tests, analysis of variance, and multivariate linear regression. RESULTS: Overall, 2826 individuals (64% non-Hispanic White, 97% with health insurance, with a median household income of $50,948) received at least one reimbursement. Median total per-patient reimbursement was $2128, median trial participation duration was 4.3 months, and monthly reimbursed amounts declined substantially throughout trial participation. Types of reimbursement varied by patient income: internet, ground transportation, and child/elder care were more common at lower income levels, whereas lodging and airfare were more common for higher incomes. In multivariate analysis, monthly reimbursed amount was greater among middle-tier household income quartiles (p = .003), greater distance to trial site (p < .001), and phase 1 trials (p = .001). The proportion of patients participating across income levels remained stable over time. CONCLUSIONS: Reimbursement needs during cancer clinical trial participation are dynamic and closely tied to both socioeconomic status and logistical burden, particularly travel distance and trial intensity. Financial support for these expenses may enhance trial accessibility and retention.
Source: Cancer
DOI: 10.1002/cncr.70625
Authors: Sukh Makhnoon, Ang Gao, Jessica L. Lee, Puja Umaretiya, Caitlyn Miller, Song Zhang, Arthi Sridhar, Erin L. Williams, Dana L. Dornsife, Robert G. Johnson, Ashley Santaniello, Loren Bryant, Navid Sadeghi, Ryan D. Nipp, Beverly Moy, Hala T. Borno, Sylvia Zhang, Darcy V. Spicer, Patrick J. Leavey, Heather E. Kitzman, Lorna Haughton McNeill, Carmen E. Guerra, David E. Gerber
Institutions: Harold C. Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Lazarex Cancer Foundation, University of California, San Francisco, UCSF Helen Diller Family Comprehensive Cancer Center, Abramson Cancer Center, University of Pennsylvania, The University of Texas MD Anderson Cancer Center, Parkland Health & Hospital System, Mass General Brigham, University of Southern California, USC Norris Comprehensive Cancer Center
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: bronze
OpenAlex ID: W7225658934