Breast cancer patients on Medicare and Medicaid at higher risk of death
Women who are on government-sponsored insurance programs are more likely to die from breast cancer, or stop treatment early.
That’s according to a new study of nearly 10,000 women, presented Thursday, Dec. 12, at the San Antonio Breast Cancer Symposium. Researchers noted that those who are covered by Medicare or Medicaid are also less likely to participate in clinical trials, signaling the need to better target this population with treatment and further research.
"Insurance appears to be a powerful determinant of clinical trial outcomes," Samilia Obeng-Gyasi, MD, a breast surgical oncologist at Ohio State University, said in a statement. “With continued changes to insurance at the federal and state levels, physicians and policymakers would benefit from having more data such as what we produced in our study.”
Obeng-Gyasi and colleagues conducted their research in conjunction with the ECOG-ACRIN Cancer Research Group, using funding from the National Institutes of Health. To reach their conclusions, they analyzed data from two chemotherapy clinical trials, concluded in 2002 and 2011.
Only about 13% of participants were on Medicare or Medicaid, while the vast majority used private insurance (more than 82% in both trials). Investigators determined that publicly insured patients were less likely to complete their treatment course and had a higher mortality rate than their privately insured counterparts. In particular, the risk of death from breast cancer was about one-third greater in the 2011 trial, and 50% greater in the 2002 version.
Meanwhile, neighborhood socioeconomic status did not affect each patient’s survival rate, or tendency to finish the clinical trial, Obeng-Gyasi and colleagues noted. Another takeaway from the study is the need to collect such detailed info during clinical trials, she added.
“Right now, most clinical trials do not collect data on social determinants of health. If they did, the information could lead us to better understand the interaction of insurance status and many other factors on the clinical outcomes of clinical trial participants,” she noted.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.