Disparities in Access to Sorafenib in Communities with Low Socioeconomic Status

J Health Care Poor Underserved. 2018;29(3):1123-1134. doi: 10.1353/hpu.2018.0083.

Abstract

Objective: In the United States, hepatocellular carcinoma (HCC) is more common among communities with low socioeconomic status (SES), and these groups tend to be diagnosed with later-stage cancers. Sorafenib is the primary treatment for advanced HCC, however its substantial cost raises concern for access to treatment.

Methods: The newly developed Case-Background method was used to estimate odds ratios for the impacts of various sociodemographic factors on sorafenib access in clinically eligible patients. Socioeconomic status was defined as a factor of median income and education level based on ZIP code of residence.

Results: There was a strong association between sorafenib prescription and residence in an area of higher SES. While controlling for age, race/ethnicity, and insurance status, high SES residence doubled the odds of sorafenib prescription (OR=2.05, p<.01).

Conclusions: Low socioeconomic status communities appear to have a reduced chance of receiving the only effective treatment for advanced HCC.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Carcinoma, Hepatocellular / drug therapy*
  • Carcinoma, Hepatocellular / pathology
  • Healthcare Disparities / economics*
  • Humans
  • Liver Neoplasms / drug therapy*
  • Liver Neoplasms / pathology
  • Neoplasm Staging
  • Residence Characteristics / statistics & numerical data*
  • Social Class*
  • Sorafenib / economics
  • Sorafenib / therapeutic use*
  • United States

Substances

  • Sorafenib