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Medicare MCO Promotes Clinical Trials

Kate Traynor

An agreement reached by two California companies could increase the participation of Medicare beneficiaries in clinical trials and lead to more information on the use of new drugs in the elderly.

PacifiCare Health Systems Inc., a managed care organization (MCO) with headquarters in Santa Ana, announced Feb. 6 that it will use the clinical trials management expertise of Santa Monica-based Protocare Inc. to expand health care services. Because more than 1 million seniors belong to PacifiCare’s Medicare+Choice plans, many of the trials sponsored by the company will investigate medical issues that affect the elderly.

"What we’re interested in are those particular disease-management areas that…affect our members," said Bary Bailey, executive vice president and chief strategic officer for PacifiCare. He said some trials will likely focus on congestive heart failure and end-stage renal failure but noted that other PacifiCare divisions, such as the MCO's behavioral health unit, also have an interest in sponsoring clinical trials. "You’ll see initiatives around migraine and other [illnesses] that we’re interested in as well."

Clinical trials sponsored by PacifiCare will be conducted outside of the traditional academic setting, said Bailey, and will recruit nonmembers and plan enrollees. The trials will be sponsored by the MCO, but day-to-day trial management will be handled by Protocare and physicians in the PacifiCare network.

According to Bailey, the MCO has been involved in Phase IV trials for about two years but is now starting to sponsor Phase II and III trials. He said that plan members seem "very interested" in participating in new trials.

Working with Protocare, said Bailey, will improve the health care that PacifiCare's 4 million members receive. "The objective is really to focus on the health and security of our members," said Bailey.

From the MCO's standpoint, sponsoring a clinical trial actually costs more money than it brings in, Bailey said, but should have a long-term benefit. Noting that PacifiCare members tend to stay with the plan for many years, he said: "We’re not just focused on the now."