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Disparities in Access to Sorafenib in Communities with Low Socioeconomic Status
- Journal of Health Care for the Poor and Underserved
- Johns Hopkins University Press
- Volume 29, Number 3, August 2018
- pp. 1123-1134
- 10.1353/hpu.2018.0083
- Article
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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.