Insurance Status Affects Anticoagulant Selection in Patients With Cancer

Insurance status is associated with whether patients with cancer receive an oral anticoagulant or a parenteral one for the prevention of venous thromboembolism, according to a study published in the journal Supportive Care in Cancer.¹

For the single-center study, investigators analyzed chart data from 457 patients with cancer and recurrent thromboembolism. Of those, 178 received oral anticoagulant therapy with warfarin or rivaroxaban and 279 received parenteral anticoagulants, such as enoxaparin, dalteparin, or fondaparinux.

Results showed that patients with Medicare were significantly more likely to have received an oral anticoagulant (P =.003), while patients with private insurance had a higher likelihood of receiving a parenteral anticoagulant (P =.004).

Researchers found that there were 23 recurrent venous thromboembolism events in total, with 6.7% and 3.94% occurring in the oral and parenteral group, respectively (P =.182).

“While there is no statistical difference in venous thromboembolism events between groups, the oral anticoagulant group numerically had a higher rate,” the authors wrote.

The study further demonstrated that the presence of an IVC filter was the only risk factor to significantly increase the risk of recurrent venous thromboembolism (odds ratio [OR], 4.38; 95% CI, 1.67-11.53; P =.003).

“These factors must be incorporated into decision making when treating cancer patients with venous thromboembolism,” the authors conclude.

Reference

1. Jean GW, Kelly K, Mathew J, Larumbe E, Hughes R. Venous thromboembolism treatment outcomes in cancer patients and effect of third-party payers on anticoagulant choice. Supp Care Cancer. 2016 Aug 20. doi: 10.1007/s00520-016-3377-x.