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Erschienen in:
30.11.2022 | Original Research
Influence of Cost-Related Considerations on Clinical Trial Participation: Results from the 2020 Health Information National Trends Survey (HINTS)
Erschienen in: Journal of General Internal Medicine | Ausgabe 5/2023
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Background
People experiencing financial burden are underrepresented in clinical trials.
Objective
Describe the prevalence of cost-related considerations influential to trial participation and their associations with person-level characteristics.
Design
This cross-sectional study used and assessed how three cost-related considerations would influence the decision to participate in a hypothetical clinical trial.
Participants
A total of 3682 US adult respondents to the Health Information National Trends Survey
Main Measures
Survey-weighted multivariable logistic regression estimated associations between respondent characteristics and odds of reporting cost-related considerations as very influential to participation.
Key Results
Among 3682 respondents, median age was 48 (IQR 33–61). Most were non-Hispanic White (60%), living comfortably or getting by on their income (74%), with ≥ 1 medical condition (61%). Over half (55%) of respondents reported at least one cost-related consideration as very influential to trial participation, including if usual care was not covered by insurance (reported by 42%), payment for participation (24%), or support for participation (24%). Respondents who were younger (18–34 vs. ≥ 75, adjusted odds ratio [aOR] 4.3, 95% CI 2.3–8.1), more educated (high school vs. <high school, aOR 2.1, 95% CI 1.1–4.1), or with lower perceived income (having difficulty vs. living comfortably, aOR 2.1, 95% CI 1.1–3.8) had higher odds of reporting any cost-related consideration as very influential to trial participation. Non-Hispanic Black vs. non-Hispanic White respondents had 29% lower odds (95% CI 0.5–0.9) of reporting any cost-related consideration as very influential to trial participation.
Conclusions
Cost-related considerations would influence many individuals’ decisions to participate in a clinical trial, though prevalence of these concerns differed by respondent characteristics. Reducing financial barriers to trial participation may promote equitable trial access and greater trial enrollment diversity.