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Question about Clinical Trials and Insurance


Jackson

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Does anyone have experience with getting into clinical trials? We have been waiting almost two weeks - first to see if my mom qualifies for the trial (she does) and now for approval from her insurance company. Someone at the insurance company told her today that they normally don't cover these types of things. Is it typical for insurance to not cover trials? We don't feel like we should be waiting around much longer and should maybe talk to her doctor about starting some other treatment.

Thanks!

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Jackson, not really sure on your question here. I am in a clinical trial for Iressa and all medication costs are covered by the organizing sponsor but they don't cover my regular doctors visits and CT scans/xrays because I would need to have them whether I am in the trial or not. That may be why they need to get the insurance company's approval?

I will be interested to see what others chime in and advise you on here.

All my best for a quick answer for you,

Wendy

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You need to check you insurance policy. Mine states NO costs associated with a trial will be covered. I posted a link last week about this in the financial forum. Besides checking your policy you need to check state law in you state. A handful require costs associated with trials to be covered.

elaine

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My experience with my clinical trial was that by definition, a clinical trial is using an experimental drug, which is almost never (except for Jimben's) covered by insurance. The drug company sponsoring the trial usually pays for anything that would not be considered "routine", such as dr. appts., blood work, routine scans, etc.

I agree with the others, your oncologist needs to help expedite this.

Good luck!

TAnn

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Thank you all for responding. The trial nurse did say that the new drug (G3139) is paid for by the trial, but I think the combo of taxol and carboplatin she will get has to be paid by insurance, and I assume the appointments and scans also. Hopefully we get some answers today. I told her to call her onc today and let him know that this is taking too long.

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When Dennis was in a clinical trial our insurance (Blue Cross) paid for all the meds and the bills for the doctor. I was always a bit confused with this, as everything I had read about clinical trials indicated that the drugs were provided at no charge to the patient in return for trial participation.

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