Immunotherapy Utilization Lower at Small and Rural Clinics

May 2, 2023

A recently published article in JAMA Oncology finds that cancer clinics that are smaller or in rural areas are less likely to use immunotherapy for their patients compared to larger clinics and those in urban and suburban areas. The study, based on Medicare claims data taken from 1700 cancer clinics, also showed that the majority of practices implemented new immunotherapies within 2 years of their approval by the US Food and Drug Administration (FDA).

According to Gianna Melillo, “Following FDA approval, immunotherapy adoption was 11 percentage points lower at rural practices than urban practices (95% CI, −16% to −6%). Adoption was also 27 percentage points lower at smaller practices than larger ones (95% CI, −32% to −22%). Investigators used 2010 Rural-Urban Commuting Area codes for each practice’s ZIP code to determine if they were urban or rural. Rural practices tended to have more non-Hispanic White patients compared with urban practices. These practices also had higher shares of patients living in ZIP codes with median household incomes below $40,000.”

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