More telemedicine in the clinic, please
Economic access to COVID testing has dominated the headlines over the last few weeks, as it should because testing is key to reducing infection rates. Basically, if a person needs a test, state and federal governments have implemented mandates that cover the costs. For treating COVID and eventually a vaccine, Medicare will provide additional payment to physicians who serve as investigators in clinical trials, lifting some of the burden from the developers of these treatments. But other diseases continue to devastate lives despite the temporary increase in COVID mortality.
Of course, clinical trials for treating these other diseases should continue (when it is safe to do so), but perhaps we should take a cue from the pandemic on how to make sure that these interventions can move through the system, and perhaps be considered for approval and payment in a more rapid fashion.
One of the significant hurdles to conducting clinical trials that I hear about from manufacturers and some investigators is that subjects – patients – cannot always be present for follow-up because of various circumstances, including socio-economic, thus the data may not always be complete. With the rallying around telemedicine and remote data collection currently, perhaps patients in future trials will not be so inaccessible.
If objective measures could be maintained, and investigators were incentivized appropriately, then there could be less worry about continuity and patient retention. It seems like now is a good time for the manufacturing and regulatory communities to begin thinking how to conduct trials in a more remote manner than in the past.