Significant survival disparities were linked to insurance status for patients with Waldenström Macroglobulinemia, according to findings presented at the 2022 ASCO Annual Meeting.

“Considerable health care resource utilization and financial burden have been associated with the treatment of Waldenström Macroglobulinemia; however, the impact of health insurance status on patient outcomes has not been explored,” said Karan Chohan, MD, internal medicine resident, Mayo Clinic, and coinvestigators.

Using data from the National Cancer Database, researchers analyzed survival outcomes for 3878 patients who were newly diagnosed with and treated for Waldenström Macroglobulinemia between 2004 and 2017. The National Cancer Database contains information on more than 70% of newly diagnosed patients with cancer across the United States, authors noted. Median follow-up was 54.6 months.

There were 1249 patients younger than 65 years of age included in the sample, of whom 62.4% were male and the average age was 58 years. For this patient group, multivariate analysis revealed individuals with nonprivate insurance had inferior survival compared to those with private insurance.

Five-year overall survival was also highest for those with private insurance (91.2%) compared to those with Medicaid (79.8%), Medicare (70.2%), and no insurance (77.4%).

Additionally, individuals in this age group who were insured under Medicaid and Medicare were more likely than those with private insurance to have a higher Charlson-Deyo comorbidity index (>1) and reside in areas of lower educational attainment and household income. Those without insurance were more likely than those with insurance to be of Black race and reside in lower income areas (P<.05).

In patients over 65 years of age (n=2629), there were no significant overall survival disparities based on insurance status (log-rank P=.096).

“Based on our study, significant insurance-based disparities exist in [Waldenström Macroglobulinemia]…While the root cause of these differences is not fully elucidated, efforts should focus on ensuring that all patients have equal access to care regardless of primary payer status,” Dr Chohan and coauthors concluded.

Reference:
Chohan K, Abeykoon JP, Ansell SM, et al. Insurance-based disparities in Waldenström Macroglobulinemia: An NCDB analysis. J Clin Oncol. 2022;40(suppl 16):abstr e19562. doi:10.1200/JCO.2022.40.16_suppl.e19562