The DoD Cancer Prevention and Treatment Clinical Trials Demonstration was conducted from 1996 through March 2008 to improve access to promising new cancer therapies, assist in meeting the clinical trial goals of the National Cancer Institute (NCI), and assist in the formulation of conclusions regarding the safety and efficacy of emerging therapies in the prevention and treatment of cancer. Effective April 1, 2008, participation in cancer clinical trials was adopted as a permanent TRICARE benefit.
Note: TRICARE beneficiaries who began participation in the demonstration prior to its termination will continue to receive services as a demonstration participant until the beneficiary is discharged from the clinical trial.
There are three types of NCI clinical trials:
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Phase I trials: Phase I trials, which are primarily concerned with assessing a drug’s safety, are not covered currently by TRICARE due to their highly experimental nature.
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Phase II trials: TRICARE beneficiaries may participate in Phase II trials, which study the safety and effectiveness of an agent or intervention on a particular type of cancer and evaluate how it affects the human body.
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Phase III trials: TRICARE beneficiaries may also participate in Phase III trials, which compare a promising new treatment against the standard approach. These studies also focus on a particular type of cancer.
Cost of Participation
TRICARE will cost-share all medical care and testing required to determine eligibility for an NCI-sponsored trial. All medical care required as a result of participation in a trial will be processed under normal reimbursement rules (subject to the TRICARE maximum allowable charge), provided each of the following conditions is met:
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The provider seeking treatment for a TRICARE-eligible beneficiary in an NCI approved protocol has obtained prior authorization for the proposed treatment before initial evaluation.
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The treatments are NCI-sponsored Phase II or Phase III protocols.
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The patient continues to meet entry criteria for the protocol.
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The institutional and individual providers are TRICARE-authorized providers.
How to Participate
Prior authorization is required to participate in an NCI clinical trial. Humana Military case managers facilitate referrals when beneficiaries are identified as possible clinical trial participants. The PCM may refer beneficiaries by contacting the demonstration case manager. Contact the South Region Cancer Clinical Trials case manager before beginning the evaluation or any treatment under the clinical trial. The toll-free number is 1-800-779-3060.
The NCI Web site lists some of the Phase II and Phase III NCI-sponsored clinical trials, but not all of them. To determine if there are clinical trials available, contact the clinical trials case manager.
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