TY - JOUR
T1 - Insurance-based disparities impact survival outcomes in Waldenström macroglobulinemia within the United States
AU - Chohan, Karan L.
AU - Abeykoon, Jithma P.
AU - Ansell, Stephen M.
AU - Gertz, Morie A.
AU - Kapoor, Prashant
AU - Paulus, Aneel
AU - Ailawadhi, Sikander
AU - Reeder, Craig B.
AU - Witzig, Thomas E.
AU - Habermann, Thomas M.
AU - Lacy, Martha Q.
AU - Kyle, Robert A.
AU - Go, Ronald S.
AU - Paludo, Jonas
N1 - Funding Information:
S.M.A receives research funding from: Bristol-Myers Squibb, Seattle Genetics, Affimed Therapeutics, Regeneron, Trillium Therapeutics, AI Therapeutics, ADC Therapeutics. M.A.G serves in a consulting/advisory role for: Prothena, Bristol-Myers Squibb, Sanofi. P.K serves in a consulting/advisory role for: Sanofi, and receives research funding from: Amgen, Takeda, Sanofi, Abbvie, GlaxoSmithKline, Sorrrento Therapeutics, Karyopharm Therapeutics, and Regeneron. S.A. serves in a consulting/advisory role for: Takeda, Celgene, Beigene, Oncopeptides, GlaxoSmithKline, and Sanofi, and receives research funding from: Pharmacyclics, Janssen Biotech, Cellectar, Phosplatin Therapeuticss, Bristol-Myers Squibb, Amgen, MedImmune, Xencor. T.E.W. serves in a consulting/advisory role for: Karyopharm Therapeutics, Celgene, Epizyme, Cellectar, Tessa Therapeutics, Portola Pharmaceuticals, ABC Therapeutics, and receives research funding from: Celgene, Acertta Pharma, Kura Oncology, Acrotech Biopharma, Karyopharm Therapeutics. T.M.H. serves on the scientific advisory board for: Eli Lilly & Co., Morphosys, Incyte, Biegene, Loxo Oncology, received research funding from Genentech, and serves on the data monitoring committee for: Seagen, and Tess Therapeutics. R.A.K serves in a consulting/advisory role for Celgene, Bristol-Myers Squibb, Pharmacyclics and Pfizer. J.P receives research funding from: Karyopharm Therapeutics and Biofourmis. The remaining authors have no disclosures to report.
Publisher Copyright:
© 2022 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2022
Y1 - 2022
N2 - Considerable healthcare resource utilization and financial burden have been associated with the treatment of WM; however, the impact of health insurance status on outcomes has not been previously reported. We conducted a National Cancer Database analysis of newly diagnosed cases of active WM between 2004 and 2017 to evaluate the impact of insurance status on outcomes. For patients <65 years old (n = 1249, male sex: 62.4%, median age: 58 years), significant insurance-based survival differences were observed on multivariable analysis; patients who were uninsured [n = 63; HR 3.11 (95%CI, 1.77–5.45), p < 0.001], on Medicaid [n = 87; HR 1.88 (95% CI, 1.01–3.48), p = 0.045], or on Medicare [n = 122; HR 2.78 (95%CI, 1.76–4.38), p < 0.001], had inferior survival compared to patients with private insurance (n = 977; reference). In patients ≥65 years, no insurance-based survival differences were found (p = 0.10). Overall, significant insurance-based outcome disparities exist in WM. Further work is desperately needed to systematically uncover and address these disparities.
AB - Considerable healthcare resource utilization and financial burden have been associated with the treatment of WM; however, the impact of health insurance status on outcomes has not been previously reported. We conducted a National Cancer Database analysis of newly diagnosed cases of active WM between 2004 and 2017 to evaluate the impact of insurance status on outcomes. For patients <65 years old (n = 1249, male sex: 62.4%, median age: 58 years), significant insurance-based survival differences were observed on multivariable analysis; patients who were uninsured [n = 63; HR 3.11 (95%CI, 1.77–5.45), p < 0.001], on Medicaid [n = 87; HR 1.88 (95% CI, 1.01–3.48), p = 0.045], or on Medicare [n = 122; HR 2.78 (95%CI, 1.76–4.38), p < 0.001], had inferior survival compared to patients with private insurance (n = 977; reference). In patients ≥65 years, no insurance-based survival differences were found (p = 0.10). Overall, significant insurance-based outcome disparities exist in WM. Further work is desperately needed to systematically uncover and address these disparities.
KW - NCDB analysis
KW - Non-Hodgkin lymphoma
KW - Waldenström macroglobulinemia
KW - healthcare
KW - lymphoplasmacytic lymphoma
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U2 - 10.1080/10428194.2022.2102623
DO - 10.1080/10428194.2022.2102623
M3 - Article
C2 - 35876190
AN - SCOPUS:85134600488
SN - 1042-8194
VL - 63
SP - 2879
EP - 2888
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 12
ER -