Evidence map›Paper›PMID 38395607›Full record

ArticleCancer2024

The 340B Program and oral specialty drugs for advanced prostate cancer.

Kassem S Faraj, Samuel R Kaufman, Mary Oerline, Lindsey A Herrel, Avinash Maganty, Megan E V Caram, Vahakn B Shahinian, Brent K Hollenbeck

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.3field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
  3. The Association of 340B Program Drug Margins with Covered Entity Characteristics.Inquiry : a journal of medical care organization, provision and financing
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Kassem S FarajDow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.ORCID https://orcid.org/0000-0002-2130-0446
Samuel R KaufmanDow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.
Mary OerlineDow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.
Lindsey A HerrelDow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.ORCID https://orcid.org/0000-0003-0221-0784
Avinash MagantyDow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.ORCID https://orcid.org/0000-0001-6436-6667
Megan E V CaramVA Health Services Research and Development, Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.ORCID https://orcid.org/0000-0003-1597-5428
Vahakn B ShahinianDivision of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Brent K HollenbeckDow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.
University of Michigan · US

Funding

Advanced Training in Urologic OncologyT32CA180984 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Ganesh S Palapattu, VAHAKN B SHAHINIAN · 2014 to 2026
$3.4M
Aligning financial incentives to promote rational use of active surveillance for prostate cancerR01CA269367 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BRENT K. HOLLENBECK, VAHAKN B SHAHINIAN · 2022 to 2026
$2.8M
Physician dispensing of oral specialty drugs for advanced prostate cancer and its implications for patientsR01CA275993 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HOLLENBECK, BRENT K., SHAHINIAN, VAHAKN B · 2023 to 2025
$2.5M
NCI NIH HHS CA180984NCI NIH HHS CA269367NCI NIH HHS CA275993NCI NIH HHS R01 CA269367NCI NIH HHS R01 CA275993NCI NIH HHS T32 CA180984
6 · The paper itself

Abstract

introductionExpensive oral specialty drugs for advanced prostate cancer can be associated with treatment disparities. The 340B program allows hospitals to purchase medications at discounts, generating savings that can improve care of the socioeconomically disadvantaged. This study assessed the effect of hospital 340B participation on advanced prostate cancer.

methodsThe authors performed a retrospective cohort study of Medicare beneficiaries with advanced prostate cancer from 2012 to 2019. The primary outcome was use of an oral specialty drug. Secondary outcomes included monthly out-of-pocket costs and treatment adherence. We evaluated the effects of 1) hospital 340B participation, 2) a regional measure vulnerability, the social vulnerability index (SVI), and 3) the interaction between hospital 340B participation and SVI on outcomes.

resultsThere were 2237 and 1100 men who received care at 340B and non-340B hospitals. There was no difference in specialty drug use between 340B and non-340B hospitals, whereas specialty drug use decreased with increased SVI (odds ratio, 0.95, p = .038). However, the interaction between hospital 340B participation and SVI on specialty drug use was not significant. Neither 340B participation, SVI, or their interaction were associated with out-of-pocket costs. Although hospital 340B participation and SVI were not associated with treatment adherence, their interaction was significant (p = .020). This demonstrated that 340B was associated with better adherence among socially vulnerable men.

conclusionsThe 340B program was not associated with specialty drug use in men with advanced prostate cancer. However, among those who were started on therapy, 340B was associated with increased treatment adherence in more socially vulnerable men.

Indexed as

Prostatic NeoplasmsAdministration, OralAgedAged, 80 and overAntineoplastic AgentsHealth ExpendituresHumansMaleMedicareRetrospective StudiesUnited StatesAntineoplastic Agentsandrogen receptor antagonistshealth care disparitieshealth policyprostatic neoplasmssocial vulnerability

Identifiers

PMID38395607
PMCPMC11139599
OpenAlexW4392773676

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.