Florida Senate - 2020 SB 840 By Senator Simmons 9-00940-20 2020840__ 1 A bill to be entitled 2 An act relating to cancer clinical trials; creating s. 3 385.2021, F.S.; providing legislative findings and 4 intent; defining terms; requiring cancer clinical 5 trial programs to inform prospective patient subjects 6 of specified reimbursements for ancillary and travel 7 expenses which may be available to them and their 8 caregivers if they participate in a cancer clinical 9 trial; specifying that reimbursement offers may not be 10 coercive or exert an undue influence and are not 11 considered inducements for participation; authorizing 12 corporations, individuals, public and private 13 foundations, health care providers, and other 14 stakeholders to offer financial assistance to support 15 approved reimbursements of ancillary and travel 16 expenses for patient subjects in a cancer clinical 17 trial and their caregivers; requiring certain entities 18 that offer reimbursement programs to secure the 19 informed consent of patient subjects; requiring that a 20 patient subject be informed of financial eligibility 21 guidelines and the reimbursement process; providing 22 that participation in a cancer clinical trial may not 23 begin without such informed consent; requiring the 24 Department of Health to review certain reimbursement 25 programs; requiring the department to approve programs 26 that meet certain criteria; requiring the department 27 to adopt rules; providing an effective date. 28 29 Be It Enacted by the Legislature of the State of Florida: 30 31 Section 1. Section 385.2021, Florida Statutes, is created 32 to read: 33 385.2021 Cancer clinical trials; communication with 34 prospective patients; offers to reimburse.— 35 (1) LEGISLATIVE FINDINGS AND INTENT.— 36 (a) The Legislature finds that: 37 1. The ability to translate medical findings from research 38 to practice relies on having robust and diverse patient 39 participation in cancer clinical trials. Low participation rates 40 or homogenous participant groups prevent segments of the 41 population from benefiting from advances achieved through 42 clinical research and create uncertainties regarding the 43 applicability of research findings. Diverse patient 44 participation in cancer clinical trials depends on the ability 45 of prospective participants to afford ancillary expenses during 46 the course of participation, a financial challenge that prevents 47 the benefits of clinical research from being equitably 48 accessible by eligible prospective participants. 49 2. Cancer clinical trials do not cover all of participants’ 50 expenses, and there are often significant uncovered expenses 51 associated with enrollment in a clinical trial. These expenses 52 may include travel expenses to and from clinical sites, such as 53 parking fees, car rentals, fuel, tolls, or lodging, and the 54 expenses incurred by the patient subject’s family, friends, or 55 individuals who attend cancer clinical trial treatments as 56 caregivers to provide emotional, physical, and mental support to 57 the patient subject. 58 3. The United States Food and Drug Administration has 59 confirmed that reimbursement of direct patient-incurred expenses 60 is a means to create equal access among potential clinical trial 61 subjects and is not considered an inducement. Despite the United 62 States Food and Drug Administration’s guidance issued to clarify 63 what constitutes an inducement, a fear of unknowingly violating 64 federal prohibitions against inducements has unintentionally 65 hindered the participation in and expansion of cancer clinical 66 trials. Corporations, individuals, public and private 67 foundations, health care providers, and other stakeholders 68 remain hesitant to contribute to or accept funds from programs 69 that are established to alleviate the financial burdens of 70 patients who wish to participate in clinical trials and their 71 caregivers. 72 (b) It is the intent of the Legislature to: 73 1. Enact legislation to distinguish between what may be 74 considered an inducement for a patient to participate and the 75 reimbursement of actual expenses associated with participation 76 in a cancer clinical trial. 77 2. Increase enrollment and retention of minority patient 78 subjects in cancer clinical trials. 79 (2) DEFINITIONS.—As used in this section, the term: 80 (a) “Cancer clinical trial” means a research study that 81 tests new cancer treatments on individuals. Treatments tested 82 may include medications, chemotherapies, stem cell therapies, 83 and similar treatments. 84 (b) “Inducement” means paying money to an individual in 85 exchange for his or her participation in a cancer clinical 86 trial. 87 (c) “Patient subject” means an individual participating in 88 a cancer clinical trial. 89 (3) COMMUNICATION WITH PROSPECTIVE PATIENTS; OFFERS TO 90 REIMBURSE.— 91 (a) Cancer clinical trial programs shall inform prospective 92 patient subjects before their participation in a cancer clinical 93 trial that: 94 1. Reimbursement for travel and ancillary expenses is 95 available to all patient subjects based on financial need; 96 2. Reimbursement for travel and ancillary expenses is 97 offered to eliminate the financial barriers to participation and 98 to help retain patient subjects in clinical trials; and 99 3. Family, friends, or individuals who attend cancer 100 clinical trial treatments as caregivers to support the patient 101 subject are eligible for reimbursement for travel and ancillary 102 expenses. 103 (b) The offer to reimburse travel and ancillary expenses 104 may not be coercive or exert an undue influence on a patient 105 subject or a potential patient subject and, in the absence of 106 such coercion or exertion of undue influence, is not considered 107 an inducement for participation in a cancer clinical trial. 108 (4) REIMBURSEMENT PROGRAMS.— 109 (a) Subject to applicable federal laws and this section, 110 corporations, individuals, public and private foundations, 111 health care providers, and other stakeholders may offer 112 financial support to cover ancillary expenses through their 113 support of reimbursement programs offered by third-party 114 nonprofit corporations and public charities to increase the 115 enrollment and retention of minority patient subjects in cancer 116 clinical trials. 117 (b) A third-party nonprofit corporation or public charity 118 that offers a reimbursement program under this subsection shall 119 implement a process for securing the informed consent of patient 120 subjects. A patient subject must be informed of financial 121 eligibility guidelines and the reimbursement process. A patient 122 subject may not begin his or her participation in a cancer 123 clinical trial in the absence of a declaration of such informed 124 consent. 125 (c) The Department of Health shall review reimbursement 126 programs offered by third-party nonprofit corporations and 127 public charities to cover ancillary and travel expenses of 128 patient subjects and their caregivers. If the department 129 determines that patient subjects are fairly recruited and 130 adequately informed in a manner that is consistent with federal 131 regulations and guidance and that ancillary and travel expenses 132 are appropriate, it must approve such programs. 133 (5) RULEMAKING.—The department shall adopt rules to 134 administer this section. 135 Section 2. This act shall take effect July 1, 2020.