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Clinical Trials and Insurance Coverage

  • Posted: 05/08/2009

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Clinical Trials and Insurance Coverage

As you think about taking part in a clinical trial, you will face the issue of how to cover the costs of care. Even if you have health insurance, your plan may not cover all of the costs related to receiving treatment in a clinical trial. This is because some health insurance companies define clinical trials as "experimental."

Costs involved in treatment clinical trials and who pays for them

There are two types of costs associated with a clinical trial: patient care costs and research costs.

Patient care costs fall into two groups:

Routine care costs are those related to treating your cancer, whether you are in a trial or receiving standard therapy. These costs include:

  • Doctor visits
  • Hospital stays
  • Lab tests
  • X-rays and scans

These costs are often covered by health insurance.

Extra care costs are those related to taking part in a clinical trial. These costs might include extra tests that you need as part of the trial, but not as part of your routine care.
These costs are not always covered by health insurance.

Research costs are those related to conducting the trial. Examples include:

  • Research doctor and nurse time
  • Analysis of results
  • Clinical tests performed purely for research purposes

These costs are often covered by the organization sponsoring the trial.