Insurance status was found to be significantly associated with survival for patients with multiple myeloma (MM), according to a study presented at the 2020 American Society of Hematology Annual Meeting & Exposition.
Researchers analyzed data from the 2007-2016 Surveillance, Epidemiology, and End Results (SEER) Program database and identified 41,846 adults with a primary diagnosis of MM. Patients were grouped by insurance status, and categorized as being uninsured, privately insured, alternatively insured, or receiving Medicaid. Patients with private insurance were more likely to be white (76%), married (65.5%), and living in metropolitan cities (90.1%), whereas the uninsured cohort had the highest proportion of Black participants (37.4%) compared with the other groups. Survival was measured at one- and five-years post-diagnosis.
After adjusting for factors such as age, sex, race, and area of residence, five-year survival was significantly lower in patients with Medicaid insurance (adjusted hazard ratio [HR], 1.44; 95% confidence interval [CI], 1.36-1.53) compared with privately insured patients. Uninsured patients had a 26% increased HR of mortality than those who were privately insured (95% CI, 1.04-1.53).
When compared with white patients, Black patients had higher likelihood of survival at both one-and five-years (HR 0.92; 95% CI 0.88-0.97). Mortality hazard increased with age, with patients over the age of 80 years having a 3.9-fold increased HR of mortality compared to those between the ages of 18 and 49 years (95% CI, 3.58-4.28).
In conclusion, the researchers wrote, “As treatment modalities for MM continue to advance, the insurance status of a patient should not hinder their ability to receive the most effective and timely therapies, as early exposure and induction are critical factors in improving the overall survival rate. Future research must focus on the cause of these disparities facing MM patients, as every individual, regardless of insurance status, should be offered the best therapies and equal treatment access.”