NCPA - National Center for Policy Analysis


October 1, 2007

Hospices are emerging as a new setting for drug trials as demand rises for medicines to address the needs of dying patients, says the Wall Street Journal.

For example:

  • Progenics Pharmaceuticals Inc., seeking approval of methylnaltrexone -- a drug designed to treat the constipation -- recently tested it among 287 patients, most of them in the final months of their lives and under the care of hospices.
  • A research team at San Diego Hospice is conducting a trial involving lidocaine, a generic anesthetic, to find out whether giving the drug intravenously can control pain in cancer patients for whom drugs such as morphine aren't enough.
  • Four Seasons Hospice & Palliative Care started its own research department and began participation in a mid-stage study sponsored by GTx Inc., a company testing a drug to treat the deterioration of muscle mass in cancer patients.

But hospices also pose thorny challenges for clinical research, says the Journal:

  • The programs typically offer physical and emotional comfort rather than cures, and are often ill-suited to handle the rigors of a clinical trial because they lack the research staff common in hospitals.
  • Ethics are another issue; some doctors and researchers worry that hospice patients' ability to make informed decisions for themselves may be impaired.

Nonetheless, hospice and palliative medicine has become an official medical subspecialty in the United States, says the Journal.  And the growing view among hospice organizations and academic researchers that dying patients have unique medical needs and not enough information on how best to meet them will only encourage more research-oriented doctors into the field.

Source: Sarah Rubenstein, "Hospices Are a Growing Venue for Drug Trials," Wall Street Journal, September 27, 2007.

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