Patients with multiple myeloma (MM) with no insurance or Medicaid coverage tended to have poorer overall survival and cancer-specific survival compared with patients with private insurance coverage, according to a recent study published in Acta Haematologica.
The study included 17,981 patients with MM aged 18 to 64 from the SEER (Surveillance, Epidemiology, and End Results) Database registries. All included patients had complete insurance records between January 2006 and December 2016.
Overall, 68.3% had private insurance and 4.9% were uninsured. The researchers found significant differences in the relationship between insurance status and overall survival and cancer-specific survival among these patients.
The multivariate regression showed that patients with no insurance had poorer overall survival (hazard ratio [HR], 1.33; 95% confidence interval [CI], 1.20-1.48; P<0.001) and cancer-specific survival (HR, 1.13; 95% CI, 1.00-1.28; P = 0.05) compared with private insurance. The same was true in patients or Medicare coverage for both overall survival (HR, 1.67; 95% CI, 1.56-1.78) and cancer-specific survival (HR, 1.25; 95% CI, 1.16-1.36; P<0.001).
“Many factors linked with healthcare availability probably regulate the relationships of no or public insurance with survival, including stage and delay of diagnosis, resulting in an advanced stage of diagnosis, delay, details and completion of treatment, receipt, Medicaid provider restrictions, or availability of data and assisting services among patients and survivors,” the researchers wrote.
The researchers also used a multiple propensity score model to adjust for potential baseline confounding. This model also showed that patients with no insurance of Medicaid coverage tended to have poorer overall survival/cancer-specific survival compared with private insurance.
“Wide insurance coverage and healthcare availability may strengthen some disparate outcomes,” the researchers wrote. “In the future, prospective cohort research is needed to further clarify concrete risks with insurance type, owing to the lack of definite division of insurance data in SEER.”