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Insurance Companies Must Cover Routine Care for Patients in Clinical Trials

Sen. Andrew Rice Sen. Andrew Rice

Steffanie’s Law Protects Seriously Ill Patients

The Oklahoma State Senate today approved legislation in a bipartisan vote making Oklahoma the 24th state to require health insurance plans to pay the cost of routine medical care for participants in a clinical trial.

The bill’s principal author, State Sen. Andrew Rice (D-OKC), called the vote a “significant victory for patients who assume that playing by the rules and paying their premiums on time means that their insurance company can’t walk away from them”.

Rice’s bill is known as “Steffanie’s Law”, named after 18-year-old Steffanie Collings, from Noble, who was diagnosed with brain cancer at the age of 14. Her insurance carrier has refused coverage since she underwent clinical trials to treat her brain tumor leaving her family with more than $400,000 in unpaid medical bills.

"Routine medical care costs" are the usual costs such as doctor visits, hospital stays, clinical laboratory tests, x-rays, etc., that patients would receive whether or not they were participating in a clinical trial. Rice said that health insurers wrongly claim that a clinical trial drives up the cost of cancer care and for this reason, they deny further coverage to patients who participate in these potential life-saving treatments.

“The current situation is a lose-lose for Oklahomans,” Rice said. “The lack of coverage is a significant barrier to many patients who don’t qualify for Medicare and can’t afford to pay medical costs independently plus it makes it harder for researchers to successfully conduct trials that could improve prevention and treatment options.”

The National Cancer Institute states that clinical trials are the only safe and effective way that new cancer treatments can be established.

Senator Rice’s plan does not seek to cover the research costs connected to the conduct of clinical trials. These costs are normally paid by the research facility or by pharmaceutical companies.

"Families in Oklahoma should not have to make this impossible choice between potential life-saving treatments and personal financial ruin," Rice said. "Studies show that there is little difference between the costs of medical care for patients who have undergone clinical trials and those who have not.”

Rice pointed to recent studies by the National Cancer Institute which confirm that the costs of allowing patients to participate in NCI-sponsored clinical trials are minimal. Participants in cancer treatment trials “do not receive more expensive services than similarly situated patients who do not enter trials,” the researchers concluded. The researchers controlled for variables such as age, extent of disease, initial treatment, and ultimate outcome so as to identify cost differences between the in-trial and out-of-trial patients that were due to trial participation alone.

"It's not right that the only obstacle to possible life-saving treatment is an insurance company which has ruled that participating in clinical trials disqualifies you from their health care coverage," Rice said.

Contact info
Senator Rice's Office: (405) 521-5610