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If You Have Cancer and Have Medicare... You Should Know About Clinical Trials

  • Posted: 07/31/2003
  • Updated: 10/01/2009

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What are cancer treatment clinical trials?

Medicare covers some costs of clinical trials. If you have cancer, you may have more choices for your treatment.

 
Cancer treatment clinical trials are research studies to find better ways to treat cancer. Clinical trials often compare the most accepted cancer treatment (standard treatment) with a new treatment that doctors hope will be better. What doctors learn in these trials will help people with cancer-now and in the future.

It is important that men and women of all ages and backgrounds take part in clinical trials. Each trial has rules about who can and cannot participate. Think about asking your doctor if you can take part in a clinical trial.

What kind of information will I get if I want to take part in a clinical trial?

Before you join a clinical trial, a doctor, nurse, or another person on the research team will explain why the trial is being done and what will happen during the clinical trial. You will be given a consent form to read.

The consent form will explain:

  • The exact plan for each step in the clinical trial
  • What side effects you may have      
  • How the trial may affect your daily life

You should ask questions about any part of the clinical trial or consent form you do not understand. If you decide to take part in the trial, you will be asked to sign the consent form. Even if you sign the consent form, you can still change your mind and stop participating at any time.


Who makes sure my rights are protected?


 
National and local groups of experts approve clinical trials before they begin. One of the most important groups is called an institutional review board (IRB).

An IRB includes doctors, nurses, and people from the community. The IRB's job is to review clinical trials and make sure they are run safely and fairly.

What cancer treatment will I get?

If you join a clinical trial that compares treatments, you will get one of the following:

  • The best accepted treatment for the kind of cancer you have (called standard treatment)    or
  • A new treatment that doctors hope will be better than the standard treatment

Why do some people choose not to be part of a clinical trial?

People may choose not to join a trial for any of the following reasons:

  • It is not known for sure if the new treatment will help you more or less than the standard treatment.     
  • Treatments in clinical trials may have unexpected side effects.
  • You may have to pay some of the costs of the trial that Medicare does not cover. It is important to talk about these costs with your health care provider.

Do I have to take part in a clinical trial?

No. Taking part in a clinical trial is up to you. It is important to look at all of your treatment options. You and your family should ask questions before you decide to take part. Be sure to get all the information you need before making your decision.


What cancer clinical trials does Medicare help pay for?


 
Medicare will help pay for most cancer treatment clinical trials that are funded by:

  • The National Cancer Institute (NCI)     
  • Other parts of the Federal Government

If I decide to take part in a clinical trial, what costs will Medicare help pay for?

Medicare will help pay for all routine costs that are part of a clinical trial.

Medicare will help pay for:

  • Visits to your doctor's office           
  • All tests that you will need for your medical care          
  • Your hospital stay(s), if you need it           
  • Surgery, if you need it           
  • Tests and treatments for side effects, if you have them

It is important to know that Medicare will not pay for all your costs.

Medicare will not pay for:

  • Some clinical trial treatments
  • Tests that collect information only for the trial, but are not needed for your medical care
  • Coinsurance and deductibles

If I am in a Medicare Advantage Plan, can I still take part in a clinical trial?

Yes. Medicare covers the costs of participating in many cancer treatment trials, whether you are in a Medicare Advantage Plan (like an HMO or PPO) or in the Original Medicare Plan.

You may take part in a trial outside of your Medicare Advantage Plan. Before you start treatment in a clinical trial, tell your plan. This way, your plan can still keep track of your cancer treatment.

If you have more questions about what costs Medicare will help pay for, call Medicare at:

1-800-MEDICARE
(1-800-633-4227).

TTY users, call
1-877-486-2048.


Questions to ask


Here are some questions to ask before you agree to take part in a clinical trial:

  • Why is the clinical trial being done?     
  • How will it help me?     
  • What kinds of tests and treatments are part of the trial?
  • How could the clinical trial change what I do every day?
  • What will happen to my cancer with or without this treatment?
  • What treatments could I get if I do not take part in the clinical trial?
  • What are possible short- and long-term side effects for me and my family to think about?     
  • How do the risks and side effects of the standard treatment compare with the new treatment?
  • How long will the clinical trial last?
  • Will I have to stay in the hospital during the clinical trial? If so, how often and for how long?     
  • Will I have check-ups after the clinical trial?
  • How long do I have to make up my mind about joining this trial?

Tip: Write out a list of your questions and concerns to ask your doctor.