Cancer Patients in Kaiser Permanente's Clinical Trials: Medical Care Costs Similar to Standard Therapy; Study Excludes Expense of Research Performed by Non-Profit HMO.Business Editors/Health and Medical Writers OAKLAND, Calif.--(BW HealthWire)--Jan. 18, 2000 When patients at a large non-profit HMO HMO health maintenance organization. HMO n. A corporation that is financed by insurance premiums and has member physicians and professional staff who provide curative and preventive medicine within certain financial, enroll in clinical trials of new cancer therapies conducted by that HMO, the costs of their medical care are only slightly higher than the costs of care for similar cancer patients not in trials, according to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. researchers with Kaiser Permanente Kaiser Permanente is an integrated managed care organization, based in Oakland, California, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney R. Garfield. (KP) in Oakland, CA. "Clinical trials are crucial to the evaluation of promising new cancer treatments, but some health plans may be reluctant to grant their members access to clinical trials because of cost concerns," says lead author Bruce Fireman. Fireman is a senior biostatistician at Kaiser Permanente's Division of Research. "When we looked at 135 cancer patients who were enrolled in our clinical trials, and compared the costs of their medical care with 135 similar cancer patients who were not enrolled in clinical trials, the care for patients in trials cost about 10% more." When patients enrolled in bone-marrow transplant trials were excluded from the analysis, the costs of care for trial enrollees were nearly identical to the costs for patients not in trials. The National Cancer Institute has recently recommended that "greater effort must be made to determine the actual costs of trials" to ensure that research into cancer treatments isn't hindered by health plans' efforts to save money. Kaiser Permanente's study is published in the January 19, 2000 issue of the Journal of the National Cancer Institute. Fireman and co-author Lou Fehrenbacher, M.D., found that the average cost of medical care for cancer patients enrolled in a clinical trial conducted by KP researchers was $17,000 during the year after enrollment, compared to the $15,500 cost during the comparable one-year period for patients not enrolled in a clinical trial. Drug costs were not included in the results because drugs used in the trial were donated. "Bone-marrow transplant trials are costly," says Fireman, "but medical care for cancer patients in other trials cost little more than it would have without trials." Fireman et al. examined the direct costs of medical care; a full accounting of the overall cost of clinical trials would also consider the costs of collecting data, including the research infrastructure necessary for good research. Kaiser Permanente participates in national multisite cancer clinical trials as part of its medical research program. The Kaiser Permanente Oncology Clinical Trials research program has involved more than 100 phase III clinical trials and 40 Kaiser Permanente oncologists to date, investigating new treatments for patients with breast cancer, colon cancer colon cancer, cancer of any part of the colon (often called the large intestine). Colon cancer is the second most common cancer diagnosed in the United States. , lymphoma, lung cancer lung cancer, cancer that originates in the tissues of the lungs. Lung cancer is the leading cause of cancer death in the United States in both men and women. Like other cancers, lung cancer occurs after repeated insults to the genetic material of the cell. and other cancers. (Phase III Noun 1. phase III - a large clinical trial of a treatment or drug that in phase I and phase II has been shown to be efficacious with tolerable side effects; after successful conclusion of these clinical trials it will receive formal approval from the FDA trials test for effectiveness drugs that have already passed earlier toxicity and safety trials. 97% of the trial enrollees whose costs were examined in this study were in phase III trials.) This ten-year-old program has enrolled more than 1000 patients since its inception. Dr. Fehrenbacher, the director of the KP oncology clinical trials program is also on the board of directors of The National Surgical Adjuvant adjuvant /ad·ju·vant/ (aj?dbobr-vant) (a-joo´vant) 1. assisting or aiding. 2. a substance that aids another, such as an auxiliary remedy. 3. Breast and Bowel Project (NSABP NSABP National Surgical Adjuvant Breast Project Oncology A series of ongoing multicenter clinical trials evaluating the effects of various therapies, including RT, surgery and chemotherapy–eg, tamoxifen and 5-FU, in treating advanced breast or colorectal CAs ), a cooperative group that was formed in 1971 to conduct clinical trials in breast cancer and colorectal cancer colorectal cancer Malignant tumour of the large intestine (colon) or rectum. Risk factors include age (after age 50), family history of colorectal cancer, chronic inflammatory bowel diseases, benign polyps, physical inactivity, and a diet high in fat. research. What are the implications of this research? Fehrenbacher says this study should spur health plans to consider broader access to oncology clinical trials for those patients who want to try them. "In my clinical experience," says Dr. Fehrenbacher, "most patients want to do all they can to beat cancer. If a patient feels that enrolling in a well designed Phase III clinical trial is the course they want to take, I think we should work hard to provide access to these trials evaluating promising new cancer therapies. Well designed and carefully conducted trials will tell us which new therapies work and which ones don't." Kaiser Permanente is America's leading integrated health care integrated health care, n healthcare services combining the best of conventional and complementary health care. organization. Founded in 1945, it is a non-profit, group-practice prepayment program with headquarters in Oakland, Calif. Kaiser Permanente serves the health care needs of 8.5 million members in 17 states and the District of Columbia District of Columbia, federal district (2000 pop. 572,059, a 5.7% decrease in population since the 1990 census), 69 sq mi (179 sq km), on the east bank of the Potomac River, coextensive with the city of Washington, D.C. (the capital of the United States). . Today, it encompasses Kaiser Foundation Health Plan Inc., Kaiser Foundation Hospitals, and the Permanente Medical Groups, as well as an affiliation with Group Health Cooperative Group Health Cooperative, based in Seattle, Washington, is a consumer-governed nonprofit healthcare system. Established in 1947, it today provides coverage and care for about 540,000 people in Washington and Idaho and is one of the largest private employers in Washington. , based in Seattle. Nationwide, Kaiser Permanente includes about 90,000 technical, administrative and clerical employees and about 10,000 physicians representing all specialties. Kaiser Permanente's website: http://www.kaiserpermanente.org National Cancer Institute website: http://www.nci.nih.gov/ Journal of the National Cancer Institute: http://jnci.oupjournals.org/ |
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