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Florida lawmakers, insurers sign deal to protect cancer trial coverage

TALLAHASSEE — State Sen. Don Gaetz and Senate President Jeff Atwater signed a compact Wednesday that guarantees major insurers will continue to cover routine care for cancer-stricken Floridians participating in clinical trials.

The senators emphasized that the agreement will improve the development of future cancer drugs and save countless lives in Florida, where cancer is the No. 2 cause of death just as it is across the nation.

Gaetz, chairman of the Senate's Health Regulation Committee, negotiated the deal with health insurance companies including Humana, Blue Cross Blue Shield of Florida, Aetna, Cigna, United Healthcare, AvMed Health Plans and Vista Healthplans. The companies are responsible for about 90 percent of Florida's group insurance market. Also supporting the deal are medical and consumer health groups including H. Lee Moffitt Cancer Center and Research Institute, the American Cancer Society and the Florida Medical Association.

"Nearly every Floridian has seen the struggles and the pains and the cost of cancer," said Atwater, R-North Palm Beach, during a news conference attended by lawmakers and insurance and medical industry representatives. "Individuals suffering and fighting cancer should not have the added stress of wondering whether their insurance will cover their care."

Florida is the fifth state to reach an agreement covering trials, and Gaetz stressed that the compact signed Wednesday won't cost taxpayers or result in higher premiums for the insured.

The voluntary compact includes "routine care" coverage for patients in Phase II, III and IV cancer clinical trials that are approved by the National Institutes of Health, National Cancer Institute, Food and Drug Administration, Defense Department or accredited Florida medical schools and specialty hospitals.

The cost of investigational drugs and therapies are typically covered by drug companies or research institutions engaged in the trials. But traditionally, insurers refuse to cover trial participants' routine care — such as doctor visits, lab tests, X-rays — in part because of concerns over liability, in part because they worry about higher costs for the insurers themselves.

That drop in routine care coverage discourages cancer patients from joining the trials, according to the National Cancer Institute. And without real patient participation, new drugs and therapies cannot be developed, the institute says.

"These clinical trials are so important," Gaetz said. "Clinical trials open the door to the next generation of cancer treatments benefiting generations of patients for years ahead."

News of the compact cheered cancer patients like Virginia Carlson, 63, of Brandon. She has Stage 4 ovarian cancer and is participating in a clinical trial at Moffitt.

Blue Cross Blue Shield agreed to continue covering her care when she joined the trial in August, more than a year after she was diagnosed.

But had the insurer not, she would not have been able to participate. The compact ensures Blue Cross will continue to pay for her medical care.

"I was very worried about losing my insurance because the costs are so prohibitive; it would have wiped out everything we had," Carlson said. "It's terrible to have to decide between a chance at living and losing your house."

Medical groups and patient advocates lauded the compact, which also ensures early treatment for cancer by requiring insurers to cover the cost of preventive care and cancer screenings.

"This compact will ensure that no patient is unfairly denied care because of his or her decision to enroll in a cancer-related clinical trial," said Tim Stapleton, executive vice president of the Florida Medical Association. "We are grateful for Sen. Gaetz's efforts."

Shannon Colavecchio can be reached at scolavecchio@sptimes.com or (850) 224-7263.

Florida lawmakers, insurers sign deal to protect cancer trial coverage 01/13/10 [Last modified: Wednesday, January 13, 2010 9:37pm]
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