Early diffusion of gene expression profiling in breast cancer patients associated with areas of high income inequality

Ninez A. Ponce, Michelle J Ko, Su Ying Liang, Joanne Armstrong, Michele Toscano, Catherine Chanfreau-Coffinier, Jennifer S. Haas

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

With the Affordable Care Act reducing coverage disparities, social factors could prominently determine where and for whom innovations first diffuse in health care markets. Gene expression profiling is a potentially cost-effective innovation that guides chemotherapy decisions in early-stage breast cancer, but adoption has been uneven across the United States. Using a sample of commercially insured women, we evaluated whether income inequality in metropolitan areas was associated with receipt of gene expression profiling during its initial diffusion in 2006-07. In areas with high income inequality, gene expression profiling receipt was higher than elsewhere, but it was associated with a 10.6-percentage-point gap between high- and lowincome women. In areas with low rates of income inequality, gene expression profiling receipt was lower, with no significant differences by income. Even among insured women, income inequality may indirectly shape diffusion of gene expression profiling, with benefits accruing to the highest-income patients in the most unequal places. Policies reducing gene expression profiling disparities should address low-inequality areas and, in unequal places, practice settings serving low-income patients.

Original languageEnglish (US)
Pages (from-to)609-615
Number of pages7
JournalHealth Affairs
Volume34
Issue number4
DOIs
StatePublished - 2015
Externally publishedYes

ASJC Scopus subject areas

  • Health Policy

Fingerprint Dive into the research topics of 'Early diffusion of gene expression profiling in breast cancer patients associated with areas of high income inequality'. Together they form a unique fingerprint.

  • Cite this

    Ponce, N. A., Ko, M. J., Liang, S. Y., Armstrong, J., Toscano, M., Chanfreau-Coffinier, C., & Haas, J. S. (2015). Early diffusion of gene expression profiling in breast cancer patients associated with areas of high income inequality. Health Affairs, 34(4), 609-615. https://doi.org/10.1377/hlthaff.2014.1013