Real-World Data Show Racial Disparities in HCC Outcomes, Resource Utilization

Tailored health interventions are necessary to reduce racial disparities in hepatocellular carcinoma (HCC) outcomes and health care resource use (HCRU), according to a study presented at the Academy of Managed Care Pharmacy 2024 annual meeting, held April 15-18 in New Orleans, Louisiana.

“HCC is rapidly increasing in the United States, yet there is a lack of comprehensive real-world data on disparities in clinical outcomes and HCRU based on race and ethnicity and socioeconomic status (SES) in the HCC space,” the authors wrote.

The retrospective study explored the impact that race and ethnicity and SES have on HCC clinical outcomes and HCRU using the Optum deidentified Market Clarity Dataset. The dataset encompasses claims linked with electronic health records (EHRs) of patients.

The study included a total of 1405 patients with HCC, all of whom were 40 years or older, with a median age of 64 years. The population was 72% male, and patients were identified between January 1, 2017, and March 31, 2022. The index date for each patient was the date of HCC diagnosis, and all patients had to have 12 months of pre- and postindex continuous medical and pharmacy eligibility or continuous clinical activity. Those who were diagnosed with HCC in the 12 months prior to the index date were excluded.

Changes in alpha fetoprotein (AFP) levels were used as a surrogate for clinical outcomes, and all-cause HCRU and AFP levels at baseline and follow-up were included. A post hoc Kruskal-Wallis test compared HCC outcomes in different racial and ethnic and SES groups. In the study population, 11% of patients were Black, 11% were Hispanic, 66% were White, 6% were Asian, and 6% were of unknown race/ethnicity.

At baseline, White patients had lower mean AFP levels than Black patients (75.34 vs 104.18; P = .0004). Black patients also had higher mean AFP values after 12 months of follow-up (52.11 vs 123.27; P = .0001). Regarding HCRU, White patients had fewer emergency department (ED) visits compared with Black patients (1.68 vs 3.03; P = .01). Although not statistically significant, White patients also had fewer inpatient visits (7.94 vs 8.23; P = .9339), outpatient visits (20.55 vs 20.56; P = 1), and office or clinic visits (17.99 vs 18.23; P = .7366). Comparisons between SES groups were not yet completed.

Overall, the findings suggest there are ongoing disparities between Black and White patients with HCC in terms of both outcomes and HCRU.

“This real-world data study highlights the existence of racial disparities in clinical outcomes and HCRU between Black and White patients with HCC. Implementing tailored health care interventions can significantly reduce these racial imbalances,” the authors concluded.

Reference

Gaur A, Sharma S, Sachdev A, et al. Examining racial and socioeconomic disparities in clinical outcomes and health care resource utilization in patients with hepatocellular carcinoma: a real-world data study. Abstract presented at: Academy of Managed Care Pharmacy 2024; April 15-18, 2024; New Orleans, LA. Abstract K14.