NIH Press Release
National Cancer Institute

Friday, September 19, 1997
12:00 PM Eastern Time

NCI Press Office
(301) 496-6641

Trish Bates
ECOG Communications
(215) 893-6436

Health Plans in Midwest Agree to Cover Patient
Care Costs of NCI Cooperative Group Sponsored Clinical Trials

PHILADELPHIA -- Cooperative Groups sponsored by the National Cancer Institute (NCI) have reached agreements with several health insurance plans in Wisconsin and Minnesota to provide more than 200,000 people in the region with coverage of the cost of patient care if they are participants in a cooperative group sponsored cancer clinical study. This represents a significant percentage of the population in these two states who will now have the benefit of this coverage.

The Cooperative Groups are NCI-supported networks of academic and community-based physicians, scientists and health care professionals across the country working together to discover the best treatments for cancer and putting their knowledge to use to benefit cancer patients. The Cooperative Group member institutions, which include community hospitals as well as university medical centers, are required to maintain high standards related to quality of care as outlined by the NCI, and to undergo routine on-site reviews to ensure that those standards are being maintained. On a national level, the Cooperative Groups already have mechanisms in place for strict quality review, data collection, and peer review.

"The level of peer review, quality control and outcomes data in the Cooperative Group clinical trials is of extreme benefit in developing clinical practice guidelines and establishing standards of care," said Robert L. Comis, M.D., chair of the Eastern Cooperative Oncology Group. "The patient benefits from the opportunity for access to the best care available and everyone else benefits from our ability to raise cancer treatment standards to the next level."

"This first agreement will serve as the model for other regional health plans to follow," said Michael O'Connell, M.D., chair, North Central Cancer Cooperative Group. "Through this program, not only will patients receive this high quality of care, but cancer care experts will have the opportunity to significantly impact the definition of the ‘standard of care' in cancer treatment, to shape the direction of future cancer research, and to affect health care payment policies."

In the United States, it is estimated that 3 percent to 5 percent of adult cancer patients participate in clinical trials. Many factors may prohibit participation; one is that cost of care on a clinical trial is frequently not covered by the patients' health plans. This landmark agreement will provide the members of these plans with greater access to high quality, state-of-the-art cancer treatment as provided on NCI Cooperative Group clinical trials.

"Cooperative Group studies have resulted in the discovery of some of the most promising new therapies for cancer, and have generated the improvements in existing cancer therapies that have the most immediate and widespread impact on the general practice of oncology. This pace of discovery depends to a great extent on how quickly patients are enrolled on clinical trials," said Richard Schilsky, M.D., chair, Cancer and Leukemia Group B (CALGB). "These agreements will enable many more patients to receive state-of-the-art treatment for cancer and, in so doing, will greatly accelerate the rate of progress toward finding a cure for this disease."

In April 1996, the Pediatric Oncology Group (POG) and the Children's Cancer Group (CCG), along with several other national organizations, formed the Pediatric Cancer Network with the Blue Cross Blue Shield Association (BCBSA). Through this pediatric network, subscribers of Blue Cross and Blue Shield Plans have immediate access to the best pediatric cancer care, coordinating the highest quality options and most cutting-edge treatment available in America today. The Pediatric Network agreement paved the way for opening discussion on expanding the coverage and access to high quality cancer care to cancer patients of all age groups. This latest agreement between the Cooperative Groups and mid-western health plans is the first that covers patient care costs for treatment on clinical trial for both adult and pediatric cancers. Discussions are taking place with health plans in other regions across the country and are expected to soon yield similar support.

"This first regional agreement is wonderful news, both for patients and for the progress of clinical research in cancer," said Robert Wittes, M.D., director of the NCI's Division of Cancer Treatment, Diagnosis, and Centers (DCTDC), and deputy director for Extramural Science. "Patients in the participating plans will have access to state-of-the-art care. In addition, the agreement will hopefully serve as a catalyst for other regional and national health plans to form similar agreements."

The NCI Cooperative Group system has been in existence for more than forty years and is responsible for developing and testing many of the treatments commonly used today in the fight against cancer. Today's latest treatments are tested in clinical trials to determine if they are more effective than current methods. Funding from the NCI, a division of the National Institutes of Health, supports the research efforts of the participating Cooperative Groups and monitors their efforts under strict guidelines. For more information on cancer care cost agreements, contact the Eastern Cooperative Oncology Group (ECOG) Chair's Office at (215) 893-6440.

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