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Considerable healthcare resource utilization and financial burden have been associated with the treatment of WM; however, the impact of health insurance status on outcomes has not been previously reported. We conducted a National Cancer Database analysis of newly diagnosed cases of active WM between 2004 and 2017 to evaluate the impact of insurance status on outcomes. For patients &lt;65 years old ( n  = 1249, male sex: 62.4%, median age: 58 years), significant insurance-based survival differences were observed on multivariable analysis; patients who were uninsured [ n  = 63; HR 3.11 (95%CI, 1.77–5.45),  p  &lt; 0.001], on Medicaid [ n  = 87; HR 1.88 (95% CI, 1.01–3.48),  p  = 0.045], or on Medicare [ n  = 122; HR 2.78 (95%CI, 1.76–4.38),  p  &lt; 0.001], had inferior survival compared to patients with private insurance ( n  = 977; reference). In patients ≥65 years, no insurance-based survival differences were found ( p  = 0.10). Overall, significant insurance-based outcome disparities exist in WM. Further work is desperately needed to systematically uncover and address these disparities.

Insurance-based disparities impact survival outcomes in Waldenström macroglobulinemia within the United States