Impact of the affordable care act on timeliness to treatment for patients with multiple myeloma

Thejus Jayakrishnan, Veli Bakalov, Natalie S. Callander, Santosh Sadashiv, Rodney Wagner, Sikander Ailawadhi

Research output: Contribution to journalArticlepeer-review


Background/Aim: To examine the impact of ACA and the association of socioeconomic factors on delay in initial treatment for multiple myeloma (MM). Patients and Methods: Patients diagnosed with MM between 2004-2016 were identified in the National Cancer Database (NCDB). Time-to-initial treatment (TTI) was defined as the number of days from diagnosis to initial therapy. Patients were classified into quartiles and those belonging to the fourth quartile for TTI constituted the delayed treatment group. Study period was divided into pre-ACA and post-ACA using 2010 as the cut-off. Results: A total of 65,723 patients met the eligibility criteria. Median TTI was 13 (IQR=5-27) days. Racial-ethnic minorities were associated with delayed-TTI. Delayed treatment was more likely for Hispanics pre-ACA but not post-ACA, while non-Hispanic Blacks (NHB) were more likely to have delayed treatment both, pre- and post-ACA. Conclusion: While ACA has been shown to help mitigate healthcare disparities in certain cancer diagnoses, the study suggests that the effect is still limited among MM patients.

Original languageEnglish (US)
Pages (from-to)5727-5734
Number of pages8
JournalAnticancer research
Issue number10
StatePublished - Oct 2020


  • Affordable Care Act
  • Disparity
  • Multiple myeloma
  • Social determinants of health

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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