Clinical trials are vital to the advancement of new treatments, but patients often feel discouraged from participating due to a variety of factors, including financial burden. The American Society of Clinical Oncology (ASCO) hosted a roundtable to discuss these financial stresses and develop recommendations, which were published in the Journal of Clinical Oncology.

Although a variety of payers — including research sponsors, Medicare, private insurance plans, and philanthropists — cover portions of investigational and routine-care costs, patients may be left to cover some routine-care costs in addition to nonmedical costs. Patients may experience gaps in routine-care coverage in cases such as when a trial facility is not in an insurance provider’s network, in addition to coinsurance and other costs. Nonmedical costs include lodging, transportation, and other expenses. Ethical concerns around sponsor support can hamper patient assistance efforts.

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The ASCO Roundtable developed 4 classes of recommendations: 

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  • Adjust policies to improve coverage for trial-associated costs, including, in part, improvement of administrative processes and cost definitions, enhanced coverage by public plans, and alternative payment options; 
  • Improve transparency of costs to patients; 
  • Adjust notions of undue inducement to allow more patient compensation; and 
  • Conduct further research into ways to minimize hardship to patients. 

With these recommendations, the ASCO Roundtable expressed hope that financial hardship could be removed as an impediment to participation in clinical trials, enhancing progress in oncology research.


Winkfield KM, Phillips JK, Joffe S, Halpern MT, Wollins DS, Moy B. Addressing financial barriers to patient participation in clinical trials: ASCO policy statement [published online September 13, 2018]. J Clin Oncol. doi:10.1200/JCO.18.01132