Senator Sherrod Brown talks to the AACR about breaking down barriers to lifesaving trials
Senator Sherrod Brown (D-Ohio) has been a steadfast supporter of biomedical research in the U.S. Senate as well as the House of Representatives, where he served from 1993 to 2006.
Last month, he was honored by the AACR, in conjunction with Friends of Cancer Research, Association of American Cancer Institutes, and the American Society for Clinical Oncology, for his support of biomedical research and for his leadership to improve access to cancer clinical trials.
Most recently, Brown led a bipartisan effort to include an amendment to the health reform bill which would protect access to clinical trials for patients with life-threatening diseases. The amendment will prohibit insurers from dropping a policyholder’s coverage if the patient chooses to participate in a clinical trial, and from denying coverage for routine care throughout the course of the clinical trial that the plan would otherwise provide.
During National Cancer Research Month in May, the AACR had the opportunity to speak with Senator Brown about his work on cancer clinical trials.
What motivated you to champion this issue?
An Ohioan named Sheryl Freeman came to see me in Washington, D.C. She was suffering from cancer, but her insurance company was not allowing her to enroll in a promising clinical trial recommended by her doctors. The insurer had included fine print in its policy that allowed it to use participation in a clinical trial as an excuse to stop paying for all routine care costs. Sheryl didn’t want the insurer to pay for the trial itself – The Ohio State University’s cancer hospital and the trial sponsor were willing to do that – she just wanted to make sure that the insurance company would cover the routine care like X-rays and blood work that she would continue to need in addition to the trial. Unfortunately, by the time the insurer relented, it was too late for Sheryl, who passed away in December 2007. This tragic story struck me as a perfect example of what’s wrong with the current system. Health insurance companies had been allowed to run amok over the last few decades, and health reform was about tipping the scales back into the consumer’s favor. I think my clinical trial provision – which would not have happened without Sheryl’s advocacy – helped do that.
Not only have cancer clinical trials led to enormous advances in the areas of cancer prevention, treatment and diagnosis, but for many patients, they present an opportunity to receive the newest, most innovative treatments for their disease. When talking to your colleagues in the Senate about your legislation, what level of understanding and support did you encounter?
Most Senators I speak with understand the importance of clinical trials. They understand the important medical advances that come from trials. But I think the problem of low participation in clinical trials, especially cancer trials, is often overlooked. And most Senators were not aware that insurance policies are being written to purposefully limit access to these potentially lifesaving trials. Once we got that message across, bipartisan support for the amendment quickly followed.
Now that your legislation is law, what role can the AACR and the cancer research community play to ensure that it is properly implemented?
The AACR and the cancer research community – in Ohio and across the country – have already done so much to advance the cause, but, ultimately, the clinical trial policy will succeed or fail based on whether or not doctors and patients know about their new rights. I’m working closely with the U.S. Department of Health and Human Services to make sure the clinical trial provision is properly implemented, which means ensuring that it applies to all insurance policies, including self-insured and federal employee plans, by the January 1, 2014, deadline. I also plan on discouraging insurers in my state and across the country from waiting until the 2014 deadline; there’s no reason insurers can’t do this sooner, and I’m hopeful that they will. But all of you, who are on the front lines in our hospitals and in our laboratories every day, can help inform your patients and the general public of their new right to clinical trials.
According to the National Cancer Institute, less than 5 percent of adults diagnosed with cancer each year will pursue treatment through enrollment in a clinical trial. Your amendment in the health care reform law will play a major role in improving that statistic, but what else do you think needs to be done to increase participation in clinical trials?
That number is clearly way too low. Lack of insurance coverage is only one barrier. Another major barrier is low public awareness. Patients often don’t know the great promise that clinical trials hold, and they fear that they will be treated like guinea pigs. Once we start doing a better job educating patients, I’m confident that low participation rates will be a thing of the past.
Sen. Brown accepts an award for his leadership to improve access to cancer clinical trials.
(From left: Dr. Stanton Gerson, director, Case Comprehensive Cancer Center; Sen. Brown;
Dr. Michael Caligiuri, director, The Ohio State University Comprehensive Cancer Center;
and Dr. William Dalton, chair of the AACR Science Policy and Legislative Affairs Committee)
Senators Introduce Bipartisan Amendment to Expand and Protect Access to Clinical Trials (Office of U.S. Senator Sherrod Brown, December 16, 2009)
Read more from the June Edition of the AACR Cancer Policy Monitor: