Insurance Status Associated with Patient Survival in Follicular Lymphoma

Privately-insured patients with follicular lymphoma (FL) have nearly 2-fold better survival outcomes compared with publicly-insured or non-insured patients, according to a new study. The findings suggest that improving access to care through insurance could potentially improve outcomes in this patient population.

The study, published in Blood, sought to examine the association between insurance status and overall survival (OS) in patients with the disease. Prior research has pointed to a link between low socioeconomic status and poor outcomes—likely due to decreased access to care among these patients. For this study, researchers looked deeper into the impact of insurance status on FL survival, which had not been previously studied.

To further explore this potential link, the researchers combed the National Cancer Database for information on patients aged at least 18 years with follicular lymphoma who were diagnosed between 2004 and 2014. The researchers examined a total of 43,648 patients in 2 groups: patients aged 18 to 64 years and patients aged 64 years and older to account for changes in insurance with Medicaid eligibility.

After adjusting for available sociodemographic and prognostic factors, patients under 65 years old with no insurance, Medicaid, and Medicare had significantly worse OS compared with privately-insured patients in the same age bracket. Among patients aged 65 and over, only those with Medicare had significantly worse OS than those with private insurance, according to the study.

The researchers also found that patients who were uninsured or had Medicare were more likely to have lower socioeconomic status, present with advanced-stage disease, have systemic symptoms, and have multiple comorbidities. In addition to insurance status, other factors including public policy, individual-level socioeconomic status, regular primary care visits, access to treatments, and care affordability should be further explored to determine their impact on FL prognosis, the researchers added.

“The findings of the study indicate that improving access to affordable, quality health care may reduce disparities in survival for those currently lacking coverage,” they concluded.

References

Goldstein JS, Nastoupil LJ, Han X, et al. Disparities in survival by insurance status in follicular lymphoma. Blood. 2018. https://doi.org/10.1182/blood-2018-03-839035.

Disparities in Follicular Lymphoma Survival Associated With Age, Insurance Status [news release]. Journal of Clinical Pathways website. https://www.journalofclinicalpathways.com/news/disparities-follicular-lymphoma-survival-associated-age-insurance-status. Accessed August 14, 2018.