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The following is a summary of “Quality of Treatment Selection for Medicare Beneficiaries With Cancer,” published in the October 2024 issue of Oncology by Mitchell et al.
The Medicare part D Low-Income Subsidy (LIS) improves access to oral cancer medications but does not cover clinician-administered drugs under part B.
Researchers conducted a retrospective study assessing the association between participation in LIS and optimal cancer treatment receipt.
They analyzed initial systemic therapy using Surveillance, Epidemiology, and End Results (SEER)-Medicare data (2015-2017) and National Comprehensive Cancer Network (NCCN) Evidence Blocks (EB) to evaluate treatment efficacy and safety. Logistic regression models assessed the relationship between the receipt of systemic therapy (vs. no treatment) plus patient and provider characteristics.
The results showed 9,290 patients, 57% (5,336) receiving systemic therapy and 43% (3,954) receiving no treatment. Compared with non-LIS, participants of LIS were less likely to receive systemic therapy (OR, 0.64 [95% CI, 0.57 to 0.72]). Among those receiving treatment, participants of LIS received treatments in the worst quartile 24.8% of the time compared to 21.9% of patients with non-LIS (adjusted prevalence difference, 4.3% [95% CI, 0.5 to 8.2]).
They concluded that participants of LIS were less likely to receive systemic therapy and more likely to receive lower-rated treatments, according to NCCN-EB.