The Cost to Patients of Participating in Clinical Trials

To the Editor.—  The article entitled "NCI Seeks to Boost Study Participation"¹ in the September 9 issue ignores the major reason that I as a community oncologist do not participate in clinical trials. The financial burden to the patient or their insurance company is a problem largely ignored by the academic community. This burden is threefold: (1) Many insurance companies will pay nothing toward the cost of therapy that they perceive as experimental. (2) Costs for travel and lodging are never covered by insurance. (3) Protocol studies always involve laboratory and roentgenogram studies that are done "for the protocol" and not for the benefit of the individual patient. Careful examination of the average clinical trial protocol will reveal at least $1000 to $2000 of such expenditure that can in no way be construed as beneficial to the individual patient. In this era of cost containment, I cannot in good conscience