High-deductible health plans linked to delays in metastatic cancer detection – Healio


Trad NK, et al. Abstract 6503. Presented at: ASCO Annual Meeting; June 3-7, 2022; Chicago.
Trad NK, et al. Abstract 6503. Presented at: ASCO Annual Meeting; June 3-7, 2022; Chicago.
CHICAGO — Patients with high-deductible health plans experienced delays in detection of metastatic cancer, according to results of an observational study presented during ASCO Annual Meeting.
“Specifically, we observed a delay in cancer diagnosis of 4.6 months,” Nicolas Karim Trad, BA, medical student at Harvard Medical School, said during his presentation.
Trad and colleagues examined the impact of high-deductible health plans on the timing of metastatic cancer detection among 345,401 individuals (mean age, 42 years; 49% female) with high-deductible health plans compared with 1,654,775 individuals (mean age, 42 years; 50% female) with low-deductible plans. Of note, both groups had a 1-year baseline period when all members were enrolled in low-deductible plans.
Researchers matched study participants according to age, sex, race/ethnicity and morbidity (ACG) score, as well as poverty level, geographic region, employer size, baseline primary cancer, baseline medical and pharmacy costs and duration of follow-up. Both the high-deductible and low-deductible cohorts had a mean ACG score of 1.4.
Researchers used a validated claims-based algorithm to detect incident metastatic cancer diagnoses and assessed time to diagnosis during baseline and follow-up using weighted Cox proportional hazards model.
Follow-up was a maximum of 13.5 years.
Researchers observed no differences in time to metastatic diagnosis at baseline (HR = 0.96). However, individuals with high-deductible health plans experienced longer time to first metastatic cancer diagnosis (HR = 0.88; P = .01), which indicated delayed cancer detection compared with the control group.
“Potential impacts of delayed cancer diagnosis include delayed initiation of palliative care and symptom-relieving therapies, as well as greater dissemination of disease, which further limits therapeutic options,” Trad said. “There were potential limitations of our study, including the fact that our data were claims-based and there was potential for unbalanced, unmeasured confounders. Looking ahead, there is a need for innovative health insurance models.”
Those models should reduce the cost-sharing burden for patients so they will not be deterred from seeking care and should align with, rather than contradict, the goal of improving cancer survival, he added.
Nicolas Karim Trad, BA, can be reached at nicolas_trad@hms.harvard.edu.
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