Disparities in access to sorafenib in communities with low socioeconomic status

Umut Sarpel, Marina Heskel, John Henry Spivack, Yael Feferman, Celina Ang, Francesca Gany

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Objective. In the United States, hepatocellular carcinoma (HCC) is more common among communities with low socioeconomic status (SES), and these groups tend to be diagnosed with later-stage cancers. Sorafenib is the primary treatment for advanced HCC, however its substantial cost raises concern for access to treatment. Methods. The newly developed Case-Background method was used to estimate odds ratios for the impacts of various sociodemographic factors on sorafenib access in clinically eligible patients. Socioeconomic status was defined as a factor of median income and education level based on ZIP code of residence. Results. There was a strong association between sorafenib prescription and residence in an area of higher SES. While controlling for age, race/ethnicity, and insurance status, high SES residence doubled the odds of sorafenib prescription (OR=2.05, p<.01). Conclusions. Low socioeconomic status communities appear to have a reduced chance of receiving the only effective treatment for advanced HCC.

Original languageEnglish
Pages (from-to)1123-1134
Number of pages12
JournalJournal of Health Care for the Poor and Underserved
Issue number3
StatePublished - Aug 2018


  • Health care disparities
  • Hepatocellular carcinoma
  • Socioeconomic status
  • Sorafenib


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