UAMS to Study Affordable Care Act's Impact on Breast Cancer Treatment

UAMS to Study Affordable Care Act's Impact on Breast Cancer Treatment

UAMS announced it has received a two-year, $222,000 grant from the American Cancer Society to support a study of the Affordable Care Act’s influence on racial disparities in the use of a common, life-saving treatment for Arkansas breast cancer patients.

The project is led by Chenghui Li, Ph.D., an associate professor in the College of Pharmacy Division of Pharmaceutical Evaluation and Policy, and an associate member of the UAMS Winthrop P. Rockefeller Cancer Institute Cancer Prevention and Population Services Program.

“Findings from this study can provide crucial insights into how the Affordable Care Act may have impacted racial disparities in getting this life-saving treatment for breast cancer,” Li said in a news release. “Our findings will have important implications for similar states in the South that have not expanded Medicaid.”

Arkansas is disproportionately affected by breast cancer, especially among Black women, UAMS said in a news release. According to Kaiser Family Foundation 2020 estimates, breast cancer mortality rate among Black women in Arkansas is 42% higher than the national average (27.2 per versus 19.1 per 100,000 women). Arkansas’ breast cancer mortality rate for white women is 19.4%.

About 80% of breast cancer patients have estrogen receptor positive tumors, which can be treated with endocrine therapy. The therapy slows or stops tumor growth by blocking estrogen production/binding onto breast cancer cells, reducing the five-year recurrence of breast cancer by 40% and mortality by 33%.

While the ACA may have helped reduce racial disparities in the use of endocrine therapy, Li said, the ongoing poor health outcomes for Black breast cancer patients raise questions about other barriers to treatment that she will explore in her research.

The study uses a unique data source: the linked Arkansas All-Payer Claims Database and Arkansas Cancer Registry, which combines claims data from all payers in Arkansas with the Cancer Registry.

“With this linked data, we will have access to detailed tumor characteristics that are lacking in claims databases with the benefit of detailed prescription information across both public and private insurers,” Li said in the release. “This presents a unique opportunity for us to systematically examine the impact of the ACA on racial disparity in endocrine therapy use.”