TY - JOUR
T1 - Racial Disparities in the Utilization of Novel Agents for Frontline Treatment of Multiple Myeloma
AU - Fiala, Mark A.
AU - Wildes, Tanya M.
AU - Vij, Ravi
N1 - Funding Information:
This research was made possible through the National Cancer Institute at the National Institutes of Health (NIH) (grant K12CA167540 ). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the National Center for Research Resources or NIH.
Funding Information:
The Center for Administrative Data Research is supported in part by the Washington University Institute of Clinical and Translational Sciences (grant UL1 TR002345 ) from the National Center for Advancing Translational Sciences of the NIH ; and the Agency for Healthcare Research and Quality (grant R24 HS19455 ).
Funding Information:
R.V. has received research funding and honoraria from Takeda, the producer of bortezomib, and Celgene, the producer of lenalidomide. The other authors have stated that they have no conflict of interest.This research was made possible through the National Cancer Institute at the National Institutes of Health (NIH) (grant K12CA167540). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the National Center for Research Resources or NIH. The Center for Administrative Data Research is supported in part by the Washington University Institute of Clinical and Translational Sciences (grant UL1 TR002345) from the National Center for Advancing Translational Sciences of the NIH; and the Agency for Healthcare Research and Quality (grant R24 HS19455). This study used the linked SEER-Medicare database. The interpretation and reporting of these data are the sole responsibility of the authors. The authors acknowledge the efforts of the Applied Research Program, National Cancer Institute; the Office of Research, Development and Information, Centers for Medicare & Medicaid Services; Information Management Services Inc; and the SEER Program tumor registries in the creation of the SEER-Medicare database.
Publisher Copyright:
© 2020
PY - 2020/10
Y1 - 2020/10
N2 - Background: Treatment with novel agents has become the standard of care for newly diagnosed multiple myeloma, but members of racial and ethnic minority groups receive these agents at a lower rate than their peers. Researchers have largely attributed this finding to the higher costs of these drugs in respect to traditional chemotherapies, but data supporting this hypothesis are lacking. We compared the relative bortezomib and lenalidomide utilization in patients with newly diagnosed multiple myeloma, hypothesizing that the disparity between white and African American patients would be greater for lenalidomide as a result of its higher overall and out-of-pocket costs. Methods: We reviewed the utilization patterns of bortezomib and lenalidomide using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Results: Bortezomib utilization was 31% less likely for African Americans compared to whites. There was no statistically significant difference in lenalidomide utilization when other factors were controlled. Conclusion: Our findings do not support the hypothesis that higher respective costs are the cause of the racial disparities in novel agent utilization for myeloma treatment. We postulate that travel or logistical issues, structural barriers in the medical system, and preferences and biases among patients and providers may also be involved in the observed treatment disparities. We reviewed the utilization patterns of bortezomib and lenalidomide using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Bortezomib utilization was 31% less likely for African Americans compared to whites. There was no statistically significant difference in lenalidomide utilization when other factors were controlled. We postulated that travel or logistical issues, structural barriers in the medical system, and preferences and biases among patients and providers may also be involved in the observed treatment disparities.
AB - Background: Treatment with novel agents has become the standard of care for newly diagnosed multiple myeloma, but members of racial and ethnic minority groups receive these agents at a lower rate than their peers. Researchers have largely attributed this finding to the higher costs of these drugs in respect to traditional chemotherapies, but data supporting this hypothesis are lacking. We compared the relative bortezomib and lenalidomide utilization in patients with newly diagnosed multiple myeloma, hypothesizing that the disparity between white and African American patients would be greater for lenalidomide as a result of its higher overall and out-of-pocket costs. Methods: We reviewed the utilization patterns of bortezomib and lenalidomide using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Results: Bortezomib utilization was 31% less likely for African Americans compared to whites. There was no statistically significant difference in lenalidomide utilization when other factors were controlled. Conclusion: Our findings do not support the hypothesis that higher respective costs are the cause of the racial disparities in novel agent utilization for myeloma treatment. We postulate that travel or logistical issues, structural barriers in the medical system, and preferences and biases among patients and providers may also be involved in the observed treatment disparities. We reviewed the utilization patterns of bortezomib and lenalidomide using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Bortezomib utilization was 31% less likely for African Americans compared to whites. There was no statistically significant difference in lenalidomide utilization when other factors were controlled. We postulated that travel or logistical issues, structural barriers in the medical system, and preferences and biases among patients and providers may also be involved in the observed treatment disparities.
KW - Access barriers
KW - Cancer disparities
KW - Inequity
KW - Race
KW - SEER-Medicare
UR - http://www.scopus.com/inward/record.url?scp=85085959561&partnerID=8YFLogxK
U2 - 10.1016/j.clml.2020.04.018
DO - 10.1016/j.clml.2020.04.018
M3 - Article
C2 - 32522440
AN - SCOPUS:85085959561
SN - 2152-2650
VL - 20
SP - 647
EP - 651
JO - Clinical Lymphoma, Myeloma and Leukemia
JF - Clinical Lymphoma, Myeloma and Leukemia
IS - 10
ER -