NSCLC: uninsured status tied to significantly poorer survival

  • Clin Lung Cancer

  • Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Median survival in uninsured patients with NSCLC is almost half that of privately insured patients.

Why this matters

  • Between 2002 and 2012, annual cancer-related health care expenditures in the U.S. increased by 46%, from $59.8 to $87.5 billion.

Study design

  • 342 patients treated with curative intent for stage III NSCLC who were uninsured (n=49) or covered by Medicare/Medicaid+Veterans Affairs (M/M+VA; n=160), or privately (n=133).
  • Funding: None.

Key results

  • Uninsured patients and those with M/M+VA were significantly more likely to have a >30-day delay from diagnosis to treatment initiation compared with the privately insured patients (67.3% vs 68.1% vs 52.6%, respectively; P=.017).
  • Uninsured patients and those covered by M/M+VA had worse median 5-year OS than those with private insurance (16.9 vs 19.0 vs 30.7 months, respectively; P<.001>
  • 5-year OS was shorter in uninsured and M/M+VA groups compared with those with private insurance (3.8% vs 17.0% vs 34.2%, respectively).
  • After multivariable analysis, uninsured patients had the worst survival (HR, 1.942; P=.027).
  • Insurance status was not associated with freedom from recurrence on multivariable analysis.

Limitations

  • Single-center, retrospective study.