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Survival in Women with De Novo Metastatic Breast Cancer: A Comparison of Real-World Evidence from a Publicly-Funded Canadian Province and the United States by Insurance Status

1
The Ottawa Hospital Cancer Centre, Ottawa, ON K1H 8L6, Canada
2
Tom Baker Cancer Centre, Calgary, AB T2N 4N2, Canada
3
Department of Medicine, Hematology Oncology, Yale New Haven Hospital, New Haven, CT 06510, USA
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2022, 29(1), 383-391; https://doi.org/10.3390/curroncol29010034
Received: 18 December 2021 / Revised: 7 January 2022 / Accepted: 12 January 2022 / Published: 16 January 2022
Metastatic breast cancer (MBC) patient outcomes may vary according to distinct health care payers and different countries. We compared 291 Alberta (AB), Canada and 9429 US patients < 65 with de novo MBC diagnosed from 2010 through 2014. Data were extracted from the provincial Breast Data Mart and from the National Cancer Institute’s SEER program. US patients were divided by insurance status (US privately insured, US Medicaid or US uninsured). Kaplan-Meier and log-rank analyses were used to assess differences in OS and hazard ratios (HR) were estimated using Cox models. Multivariate models were adjusted for age, surgical status, and biomarker profile. No difference in OS was noted between AB and US patients (HR = 0.92 (0.77–1.10), p = 0.365). Median OS was not reached for the US privately insured and AB groups, and was 11 months and 8 months for the US Medicaid and US uninsured groups, respectively. The 3-year OS rates were comparable between US privately insured and AB groups (53.28% (51.95–54.59) and 55.54% (49.49–61.16), respectively). Both groups had improved survival (p < 0.001) relative to the US Medicaid and US uninsured groups [39.32% (37.25–41.37) and 40.53% (36.20–44.81)]. Our study suggests that a universal health care system is not inferior to a private insurance-based model for de novo MBC. View Full-Text
Keywords: overall survival; breast neoplasm; insurance status; United States; Canada overall survival; breast neoplasm; insurance status; United States; Canada
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MDPI and ACS Style

Savard, M.-F.; Kornaga, E.N.; Kahn, A.M.; Lupichuk, S. Survival in Women with De Novo Metastatic Breast Cancer: A Comparison of Real-World Evidence from a Publicly-Funded Canadian Province and the United States by Insurance Status. Curr. Oncol. 2022, 29, 383-391. https://doi.org/10.3390/curroncol29010034

AMA Style

Savard M-F, Kornaga EN, Kahn AM, Lupichuk S. Survival in Women with De Novo Metastatic Breast Cancer: A Comparison of Real-World Evidence from a Publicly-Funded Canadian Province and the United States by Insurance Status. Current Oncology. 2022; 29(1):383-391. https://doi.org/10.3390/curroncol29010034

Chicago/Turabian Style

Savard, Marie-France, Elizabeth N. Kornaga, Adriana M. Kahn, and Sasha Lupichuk. 2022. "Survival in Women with De Novo Metastatic Breast Cancer: A Comparison of Real-World Evidence from a Publicly-Funded Canadian Province and the United States by Insurance Status" Current Oncology 29, no. 1: 383-391. https://doi.org/10.3390/curroncol29010034

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