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Study Finds Insurance-Based Disparities in Breast Cancer Trial Outcomes

December 13, 2019

Compared with those with private insurance, participants in breast cancer clinical trials with Medicare, Medicaid, or other government insurance were less likely to complete trials and had a lower survival rate. Researchers presented their findings during a session at the San Antonio Breast Cancer Symposium in San Antonio, Texas.

“Studies have shown an association between insurance status, socioeconomic status, and disparities in clinical outcomes among breast cancer patients,” researchers explained in the session abstract. “The objective of this study was to evaluate insurance status and socioeconomic status with respect to protocol treatment completion and survival among participants in two large randomized adjuvant breast cancer clinical trials.”

The study included a total 9790 participants from two ECOG-ACRIN Cancer Research Group clinical trials: E1199 and E5103. About 83% of participants had private insurance.

While participants with Medicare, Medicaid, or other government insurance were less likely to complete treatment per protocol and had increased association with death compared with participants with private insurance, researchers found no such association in protocol treatment completion or survival when they compared self-pay patients with those with private insurance.

Furthermore, participant socioeconomic status was not associated with protocol treatment completion or survival.

“In these two clinical trials, patients with government-type insurance appeared to face barriers in trial treatment completion and had a lower survival compared to their privately insured counterparts,” researchers wrote. “Future studies are encouraged to focus on patient- and institution-related variables that might be contributing to these insurance-based disparities in outcomes.”

—Jolynn Tumolo


Obeng-Gyasi S, O’Neil A, Zhao F, et al. Impact of insurance and socioeconomic status on clinical outcomes in therapeutic clinical trials for breast cancer. December 13, 2019.

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