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JNCI Journal of the National Cancer Institute 2004 96(14):1048-1049; doi:10.1093/jnci/djh225
© 2004 by Oxford University Press
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© 2004 Oxford University Press

EDITORIAL

Barriers to Clinical Trial Enrollment: Are State Mandates the Solution?

Bruce E. Hillner

Correspondence to: Bruce E. Hillner, MD, Department of Internal Medicine and the Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23298-0170 (e-mail: hillner@hsc.vcu.edu)

The first 10% of the full text of this article appears below.

Everyone agrees that optimal medical care should be based upon a database of evidence derived from patients participating in comparative randomized clinical trials. Unfortunately, there are numerous barriers to building this database. The design, recruitment, and analysis of these trials are expensive and enmeshed with potential conflicts of interest (1,2). A variety of approaches has been suggested to enhance public participation in clinical research (3).

One easy-to-identify barrier is uncertainty about third-party insurers paying for care. Because no consensus in the United States about who is financially responsible for paying for these clinical trials has been reached, it is not surprising that private insurance plans have been reluctant to pay for care provided as . . . [Full Text of this Article]


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