In 2000, Medicare policy changed to cover routine medical costs for Medicare patients enrolled in clinical trials. The policy change increased the percentage of older adults in clinical trials but only for those Medicare recipients who also had supplemental insurance. Those with Medicare coverage only were no more likely to be part of a clinical trial.
In a [study reported in an early online edition of the *Journal of Clinical Oncology*](http://www.jco.org/cgi/content/abstract/JCO.2005.02.8928v1?etoc) analysts from the Southwest Oncology Group (SWOG) compared the percentages of patients 65 and over enrolled in SWOG clinical trials before and after the Medicare policy change.
Previously, from 1993-1996, 25% of patients in SWOG clinical trials were 65 or older, while 63% of people with cancer were at least 65 years of age. From 1997 through 2000, the year that Medicare policy changed, 31% of SWOG enrollees were at least 65. In the years 2001 through 2003, the percentage increased to 38%.
However, in analyzing payment patterns, the researchers found that the increase in enrollment was true only for those Medicare patients who also had supplemental insurance.
Joseph M. Unger and the SWOG team concluded:
Method of payment analyses provided evidence that the Year 2000 Medicare policy change had a positive impact, but only for those patients with supplemental private coverage of coinsurance costs. Improvements in the Medicare payment structure could further increase older patient participation in clinical trials.