ASCO: Study explores impact of health insurance and survival rates for multiple myeloma

Health insurance and other socio-economic data are associated with longer survival rates for patients with multiple myeloma.

A study, presented at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago today, shows the other socio-economic factors including living in a higher-income area and treatment in certain practice settings all influenced survival rates.

While an estimated 32,000 people in the United States are diagnosed with multiple myeloma each year, the study’s researchers examined data from 117,926 individuals living with multiple myeloma from 2005 to 2014. The median age at diagnosis was 67, the researchers say.

Other demographic factors reported in this cohort:

•    55 percent male and 45 percent were female

•    57 percent of people lived in areas where the median income was under $46,000 a year, while 43 percent earned more than $46,000 a year

•    Medicare accounted for 52 percent of enrollees, 35 percent had private insurance, 5 percent were on Medicaid, and 3 percent were uninsured

•    40 percent were treated in an academic comprehensive cancer program, 39 percent in a comprehensive community program, 9 percent in a community cancer program, and 10 percent in an integrated network cancer program that offers comprehensive services

Lead study author Kamal Chamoun, MD, a fellow with the Hematologic Malignancies and Stem Cell Transplant Program at the University Hospitals in Cleveland, Ohio, explains that as healthcare costs rise, gaining a better understanding of the economic impacts or barriers to care are important. “Prices of oral cancer drugs have been rapidly escalating, especially for patients and survivors of multiple myeloma, and we need to take action to limit and reverse the disparity for those who cannot afford private insurance or have lower incomes,” Chamoun says in a prepared statement.

Some of the key findings presented at ASCO, include:

•    People with private insurance had a 59 percent greater probability of survival than those insured through Medicaid.

•    People with private insurance had a 62 percent greater likelihood of survival than those who had no health insurance.

•    For people age 65 and older, those who had private health insurance lived longer than those who had Medicare.

•    People with a higher median regional income of $46,000 or more had a 16 percent greater chance of surviving than people with incomes less than $46,000 a year.

•    Lower Charlson Comorbidity scores, which predict the risk of death within one year of hospitalization for people with 19 different comorbid conditions, were also associated with a greater probability of survival.

•    A lower percentage of people receiving Medicare or Medicaid traveled more than 120 miles to a treatment facility compared to people with private insurance.

While the study did not explore the long-term impacts of medication costs on treatment, Chamoun notes that people experiencing economic challenges can lead to “higher rates of treatment interruption or discontinuation.” Also, the study’s findings assert that Medicaid enrollees “often lack strong social support networks to provide transportation or other non-medical assistance.” Treatment of multiple myeloma often requires complex and regular care, and access to care can be limited in rural areas (for those having to travel 200 miles roundtrip).

The study, ASCO reports, was funded at the Seidman Cancer Center.