Deal opens access to cancer trials

COLUMBIA -- Insurance companies for thousands of cancer patients in South Carolina will now pay for treatments in clinical trials under a new voluntary agreement announced Tuesday at the Statehouse.

The agreement -- worked out by the South Carolina Cancer Alliance and the South Carolina Alliance of Health Plans, and facilitated by legislators -- will speed up the development of new cancer drugs, in addition to covering the cost of lab work, doctors appointments and routine patient care for those in clinical trials. The insurance coverage will begin July 1.

Terri Matson, director of the Clinical Trials Office at the Hollings Cancer Center, said roughly 100,000 men, women and children in the state are living with cancer. More than 22,000 are diagnosed each year, she said.

Hollings is a National Cancer Institute-designated cancer center at the Medical University of South Carolina.

At any given time, MUSC is offering 150 clinical trials, Matson said. Statewide, as many as 1,000 clinical trials could be under way.

"This is a monumental occasion, five years in the making," Matson said. "It really provides opportunities for every single cancer patient that's currently in treatment."

One clinical trial alone could enroll as many as 5,000 or 6,000 cancer patients, she said.

Participating in the agreement are members of the state Alliance of Health Plans, including BlueCross BlueShield, BlueChoice, Carolina Care Plan and UnitedHealthcare of the Carolinas.

The clinical trials will be covered by Medicare but not Medicaid.

More providers could join the voluntary agreement in the future.

Scott Broome, service line director for Oncology Services at Roper St. Francis Cancer Center, said in a statement that the agreement will benefit patients receiving treatment at any South Carolina hospital offering clinical trials, including community hospitals.

Cancer patients across the state can speak to their physicians to find out more about clinical trials in their area.

Before the agreement, cancer patients who were denied insurance coverage for the clinical trials either paid for them out of pocket or chose to forgo the treatment, unless the health care provider offered free spots.

Matson said appealing an insurance company decision is often a three- to four-week ordeal, and many cancer patients don't have the time to wait.

Insurance companies had considered the clinical trials experimental and denied coverage on that basis, although the decision to deny the coverage varied by company.

Rep. Anne Peterson Hutto, D-Charleston, said the agreement will save lives.

Hutto was a sponsor on a bill that would have required the agreement from insurance companies, if they hadn't reached it voluntarily.

"This will enable more people to take part in cancer trials," she said.

"It will enable our researchers to go further. It takes many, many trials and many, many failed attempts to create a new working cancer drug. Today, goes a long way toward making this happen more often in South Carolina."

More than 30 states and Washington, D.C., have similar agreements, either developed voluntarily or through legislative directive.

About 12 to 13 percent of the cancer patients at MUSC are treated in clinical trials, but nationally just 3 to 5 percent of cancer patients are in clinical trials, Matson said.