Limited stage, limited access.

An NCDB analysis of patterns of care for patients with limited stage small cell lung cancer (LS-SCLC) shows that only about 50% of patients actually receive the gold standard of combined chemoradiation. 20% receive no treatment at all. What's more, combo chemoradiation close to doubled median survival when compared to either monotherapy. When examining economic barriers to standard care, the authors found--to no big surprise--being uninsured reduced the chances of getting chemo and/or radiation. Where it gets really interesting, patients with Medicaid or Medicare had reduced chances of getting radiation but not of getting chemo. The authors stipulate this may be due to programs like the 340b drug pricing program that allow patients with government insurance to better access chemotherapy...but not radiation therapy. The 340b program is a touchy subject, but broadening its scope to subsidize optimal comprehensive cancer treatments could improve patients’ access to quality care, even when it calls for more than a drug.