• Courtney P Williams, Ann M Geiger, Wynne E Norton, Janet S de Moor, and Nicole Senft Everson.
• Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA. courtney.williams@nih.gov.
• J Gen Intern Med. 2023 Apr 1; 38 (5): 120012061200-1206.

BackgroundPeople experiencing financial burden are underrepresented in clinical trials.ObjectiveDescribe the prevalence of cost-related considerations influential to trial participation and their associations with person-level characteristics.DesignThis cross-sectional study used and assessed how three cost-related considerations would influence the decision to participate in a hypothetical clinical trial.ParticipantsA total of 3682 US adult respondents to the Health Information National Trends Survey MAIN MEASURES: Survey-weighted multivariable logistic regression estimated associations between respondent characteristics and odds of reporting cost-related considerations as very influential to participation.Key ResultsAmong 3682 respondents, median age was 48 (IQR 33-61). Most were non-Hispanic White (60%), living comfortably or getting by on their income (74%), with ≥ 1 medical condition (61%). Over half (55%) of respondents reported at least one cost-related consideration as very influential to trial participation, including if usual care was not covered by insurance (reported by 42%), payment for participation (24%), or support for participation (24%). Respondents who were younger (18-34 vs. ≥ 75, adjusted odds ratio [aOR] 4.3, 95% CI 2.3-8.1), more educated (high school vs. ConclusionsCost-related considerations would influence many individuals' decisions to participate in a clinical trial, though prevalence of these concerns differed by respondent characteristics. Reducing financial barriers to trial participation may promote equitable trial access and greater trial enrollment diversity.© 2022. The Author(s), under exclusive licence to Society of General Internal Medicine.

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