Barriers and facilitators to enrolling in a cancer clinical trial financial reimbursement program.

Abstract

e18641 Background: Cancer clinical trial (CCT) participants often have significant out-of-pocket expenses. These expenses may disproportionately burden lower income participants. To increase access to CCTs, the Lazarex Cancer Foundation (LCF) created the Improving Patient Access to Cancer Clinical Trials (IMPACT) Program, a financial reimbursement program for out-of-pocket travel and lodging expenses. This study was designed to evaluate the barriers and facilitators to enrolling and participating in the IMPACT Program. Methods: This qualitative study consisted of semi-structured interviews with a subset of CCT participants at the Abramson Cancer Center (ACC) of the University of Pennsylvania who enrolled in the IMPACT Program and consented to this study. The interview focused on barriers and facilitators of enrolling in the program and suggestions for improving enrollment. The interviews were analyzed using grounded theory methods of analysis. Results: From May 2021 to January 2023, 75 patients enrolled in the program and 31 patients participated in the interview (57% Female, 93% White, Median Age (SD) = 66.0 years (13.6)). The most common cancers represented in this population were hematological, gastrointestinal, and breast cancers (37.3%, 16.0%, and 13.3%, respectively). The table shows the reported barriers and facilitators of enrolling in IMPACT. The most commonly cited barriers were related to the process of enrollment (participants wished to be contacted earlier before accruing expenses) and patient barriers (technology access and privacy concerns). The most common facilitator to enrollment was receiving assistance and explanation from ACC IMPACT coordinators. Participant suggestions for improving enrollment in IMPACT include earlier introduction of the program to potential clinical trial participants during the informed consent process and offering navigation services for cancer center resources. Conclusions: Out-of-pocket expenses related to clinical trials can be addressed through financial reimbursement programs. To optimize the benefit of these programs, it is ideal to enroll patients at the time of informed consent, establish IMPACT coordinators, and use technology to streamline the enrollment and submission process. [Table: see text]