Newswise — BOSTONApril 16, 2024 /PRNewswire/  Researchers from Analysis Group, a global leader in health economics and outcomes research (HEOR), have coauthored the first large-scale study that revealed racial disparities in treatment, survival, and access to care among patients with metastatic castration-sensitive prostate cancer (mCSPC) since the first  novel hormonal therapy was approved in 2018. The study, published in the journal Prostate Cancer and Prostatic Diseases, found that Black patients were significantly less likely to receive novel treatments for – and were at a higher risk of death from – mCSPC than white patients.

The study evaluated treatment intensification (TI) and overall survival (OS) among 18,297 Medicare and 3,384 Veterans Health Administration (VHA) mCSPC patients to understand access to care and health outcomes by race and socioeconomic status. Following medical guidelines for treating mCSPC, the study defined TI as patients receiving docetaxel; novel hormonal therapy (abiraterone, apalutamide, or enzalutamide); or both, in addition to androgen deprivation therapy (ADT).  

The findings show that:

  • Black patients were far less likely to receive TI than white patients (32% less likely in Medicare; 25% less likely in VHA).
  • Black patients had a 20% higher risk of death than white patients within the Medicare population. There was no significant difference in OS between Black and white patients in the VHA population.
  • Overall TI rates for all patients were modest (10.3% in Medicare; 19.9% in VHA), despite being recommended by treatment guidelines.
  • Within the Medicare population, patients dually enrolled in Medicaid were 33% less likely to receive TI and had a 50% higher risk of death than those without Medicaid.

"Understanding the care of patients is critical to ensuring that treatments are made available to those who need them, regardless of race or socioeconomic status," said study investigator Hongbo Yang, a Managing Principal at Analysis Group. "This study highlights a concerning disparity in emerging care for mCSPC, despite the availability of life-prolonging treatments."

The study, "Emerging racial disparities among Medicare beneficiaries and Veterans with metastatic castration-sensitive prostate cancer," was published in April by Prostate Cancer and Prostatic Diseases and summarized in a video by lead investigator, Dr. Daniel J. George of the Duke Cancer Institute.

In addition to Dr. Yang and Dr. George, investigators included Vice President Wei Gao and Manager Wei Song of Analysis Group; Dr. Rhonda L. Bitting of the Duke Cancer Institute and the Durham VA Medical Center; Dr. Stephen J. Freedland of Cedars-Sinai Medical Center and the Durham VA Medical Center; Dr. Neeraj Agarwal of the Huntsman Cancer Institute; Dr. Zachary Klaassen of the Georgia Cancer Center;  Krishnan Ramaswamy, David Russell, Birol Emir, Rickard Sandin, and Agnes Hong of Pfizer; and Yilu Lin of Tulane University. Funding for this study was provided by Pfizer and Astellas Pharma.

To learn more about Analysis Group's HEOR capabilities, visit

About Analysis Group's HEOR, Epidemiology & Market Access Practice
Founded in 1981, Analysis Group is one of the largest international economics consulting firms, with more than 1,200 professionals across 14 offices. Analysis Group's health care experts apply analytical expertise to health economics and outcomes research (HEOR), clinical research, market access and commercial strategy, and health care policy engagements, as well as drug safety-related engagements in epidemiology. Analysis Group's internal experts, together with our network of affiliated experts from academia, industry, and government, provide our clients with exceptional breadth and depth of expertise and end-to-end consulting services globally.

Journal Link: Prostate Cancer and Prostatic Diseases