Financial Toxicity and Equitable Access to Clinical Trials

Area of Science:

• Oncology
• Health Services Research
• Health Economics

Background:

• Financial toxicity, stemming from high costs and financial burden, negatively impacts patient care and outcomes.
• Despite potential survival benefits, less than 5% of adult cancer patients enroll in clinical trials.
• Enrollment disparities exist across age, ethnicity, and sociodemographic factors, with at-risk populations underrepresented.

Purpose of the Study:

• To investigate financial barriers impacting clinical trial enrollment.
• To highlight disparities in clinical trial participation.
• To propose solutions for improving equitable access to cancer clinical trials.

Main Methods:

• Literature review and analysis of existing research on financial toxicity and clinical trial enrollment.
• Examination of sociodemographic factors influencing participation.
• Synthesis of policy and practical recommendations.

Main Results:

• Financial concerns and insurance issues are significant obstacles to clinical trial enrollment for specific patient groups.
• Younger, poorer, and nonwhite patients, who are at higher risk for financial toxicity, are less likely to enroll.
• Existing disparities in trial access are linked to socioeconomic and demographic factors.

Conclusions:

• Addressing structural and clinical barriers is essential to increase clinical trial enrollment.
• Policy changes for insurance coverage of standard care in trials are needed.
• Financial assistance for indirect costs, education, and cost transparency can improve equitable access.