Temporal trends and geographic differences of insurance coverage for cancer drug trials in mainland China

Abstract

Background Data on insurance coverage of cancer drug trials in mainland China was of paucity, especially for its time trend and regional difference. Methods Based on the national authoritative database, time trend analysis of insurance coverage of cancer drug trials was conducted, from both the perspectives of trials and participants. Meanwhile, group comparisons by region, drug type and study phase, were also performed. Mann-Kendall test was used for trend analysis, and chi-square test was used to conduct group comparisons. Results A total of 1889 clinical trials were included, with 333 being international trials. In average, the insurance rate of trials was 79.8%, and it was steadily increased by 6.8% annually from 2010 to 2019. While the insurance coverage of Chinese participants was 67.6%, and it showed a wavy upward trend. Compared with international trials (91.9%), insurance rate of domestic trials (77.2%) was significantly lower (P < 0.001), but the rate gap decreased gradually. The comparisons by region showed that, the insurance rate in Northeast China (86.6%) was the highest, while that for Northwest China (40.0%) was lowest. Additionally, traditional Chinese medicine trials, and BE studies had significantly lower rate of insurance. Conclusion The insurance coverage of cancer drug trials in mainland China has been increasing steadily over the past decade. However, the regional differences are significant. To promote insurance coverage emphatically in underdeveloped areas could be our work emphasis. Although this study specially included cancer drug trials, the results could also provide reference for trials in all other fields.