Study Shows Insurance-Based Survival Disparities Widen Post-Introduction of Immune Checkpoint Inhibitors

A study led by the American Cancer Society analyzed the impact of immune checkpoint inhibitors (ICIs) on survival disparities among patients aged 18 to 64 with stage IV melanoma, non–small cell lung cancer (NSCLC), and renal cell carcinoma. By examining data from the National Cancer Database, researchers assessed 2-year survival rates before and after FDA approval of ICIs, highlighting differences between privately insured, uninsured, and Medicaid-covered patients.

The study found a significant widening in survival gaps between uninsured and privately insured patients following the introduction of ICIs, with improvements in survival more pronounced among those with private insurance. For melanoma, 2-year survival for uninsured patients rose from 16.2% to 28.3%, whereas for those privately insured it increased from 28.7% to 46.0%, amplifying the disparity by 6.1 percentage points.

A smaller but notable increase in survival disparity was observed with NSCLC. However, survival differences between Medicaid beneficiaries and the privately insured remained largely unchanged after ICIs introduction. The findings emphasize the role of insurance coverage in access to advanced cancer therapies and resultant survival outcomes. Researchers call for federal policies to expand insurance coverage and lower treatment costs to help mitigate these disparities. The study underscores ongoing healthcare inequalities in access to costly, innovative cancer treatments and their effect on patient outcomes.