Association of insurance types and outcomes in acute promyelocytic leukemia

Abstract

Understanding the association between insurance status and survival in an evolving US healthcare system remains a challenge but is essential to address healthcare disparities. We utilized National Cancer Database to evaluate the effects of insurance type on one-month mortality and overall survival (OS) in patients with acute promyelocytic leukemia. Among patients <65 years, one-month mortality was worse for uninsured patients and patients with Medicare compared to patients with private insurance. OS was similar between patients with private insurance and uninsured patients but worse for patients with Medicare and Medicaid/other government insurance. In multivariate analysis, older age and greater comorbidity burden conferred worse OS. For patients ≥65 years, insurance type did not affect one-month mortality and OS. Older age, greater comorbidity burden, and treatment at non-academic centers conferred worse one-month mortality and OS. Our results highlight healthcare disparities based on insurance types for both younger and older patients.

Keywords:

• Acute promyelocytic leukemia
• health care disparities
• insurance
• mortality
• overall survival

Disclosure statement

Vijaya Raj Bhatt reports participating in Safety Monitoring Committee for Protagonist, and receiving consulting fees from Genentech, Incyte, Servier Pharmaceuticals LLC, and Abbvie, research funding (institutional) from Abbvie, Pfizer, Incyte, Jazz, and National Marrow Donor Program, and drug support (institutional) from Oncoceutics for a trial. Krishna Gundabolu reports receiving consulting fees from Bayer consumer care, CTI biopharma, BMS, Blueprint Medicines, Jazz Pharmaceuticals, and BioMarin Pharmaceuticals, and research funding (institutional) from Samus Therapeutics, Incyte, and Pfizer. There are no conflicts of interest for any other authors.

These study findings were presented in an abstract form at the American Society of Hematology Annual Meeting held in December 2021.

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article [and/or] its supplementary materials.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.