Precision medicine testing in ovarian cancer: The growing inequity between patients with commercial vs medicaid insurance.
Gynecol Oncol
; 162(1): 18-23, 2021 07.
Article
en En
| MEDLINE
| ID: mdl-33958212
ABSTRACT
INTRODUCTION:
Precision medicine technologies have significant impact in the care of patients with ovarian cancer. Compared to affluent patients, socioeconomically vulnerable patients are less likely to have access to this testing. There is little data that demonstrate this inequity over time.METHODS:
We used the IBM Truven Health MarketScan Research Database to identify patients in the United States who underwent surgery for ovarian cancer between 2011 and 2017. The presence of claims for precision medicine testing within six months of surgery was assessed for each patient. Precision medicine testing included both molecular genetic testing (BRCA limited or full sequencing, somatic and germline testing) as well as ancillary pathology tests (immunohistochemistry, microsatellite instability). Demographic data was extracted.RESULTS:
We identified 27,181 patients who met eligibility. Of these, 88.6% had commercial insurance, and 11.4% had Medicaid. While the proportion of patients who underwent precision medicine testing increased over time for both cohorts (47.0% to 66.6% for commercially insured, 41.4% to 57.6% for Medicaid insured, p < 0.0001), the inequity in testing rates widened (5.6% disparity to 9.0%, p < 0.0001). This was driven by growing inequity in germline and somatic genetic testing (7.6% disparity to 21.3%, p < 0.0001).CONCLUSIONS:
There is widening inequity in precision medicine testing rates between commercially insured and Medicaid insured poate patients with ovarian cancer.Palabras clave
Access to care; Claims database; Delivery of health care; Genetic testing; Genomics; Health disparities; Health equity; Health services accessibility; Immunohistochemistry; Inequities; Insurance coverage; Medicaid; Microsatellite instability; Molecular testing; Ovarian neoplasms; Pathology; Patient Protection and Affordable Care Act; Policy; Precision medicine; Whole genome sequencing
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias Ováricas
/
Medicaid
/
Equidad en Salud
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Disparidades en Atención de Salud
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Medicina de Precisión
/
Seguro de Salud
Tipo de estudio:
Prognostic_studies
Límite:
Adult
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Female
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Humans
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Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Gynecol Oncol
Año:
2021
Tipo del documento:
Article