Inequities in supportive care medication use among older adults with metastatic pancreatic adenocarcinoma

Purpose: The purpose of this study is to assess racial/ethnic differences in supportive care medication use over time among older adults with pancreatic adenocarcinoma. Methods: We used the Surveillance, Epidemiology, End Results (SEER)-Medicare linked database to identify Medicare Part D beneficiaries who were diagnosed with distant or metastatic pancreatic adenocarcinoma from January 2008 to December 2019. We used modified Poisson regression to estimate the likelihood of using any nonopioid psychotropic medication, opioid pain medication, pancreatic enzyme replacement therapy (PERT), and supportive care medication (composite measure of aforementioned medications) over the entirety of the study period (2008–2020) and in 2-year increments. Results: Among the 29,266 beneficiaries included in this study, 12.4% were non-Hispanic Black and 12.4% were Hispanic. Compared to non-Hispanic White beneficiaries, non-Hispanic Black beneficiaries had a lower probability of any supportive care medication use from 2008–2009 (adjusted risk ratio (aRR) 0.83, 95% CL 0.77–0.90) to 2018–2019 (aRR 0.89, 95% CL 0.85–0.94). Findings were similar for any nonopioid psychotropic medication, opioid pain medication, and PERT. Inequities in any supportive care medication use narrowed from 2008–2009 (aRR 0.88, 95% CL 0.81–0.95) to 2018–2019 (aRR 0.98, 95% CL 0.93–1.02) for Hispanic beneficiaries. Although similar trends were observed for opioid pain medications, Hispanic beneficiaries had a lower probability of using any nonopioid psychotropic medication and PERT relative to their non-Hispanic White counterparts. Conclusion: Racial/ethnic inequities in the use of many supportive care medications persisted over time. Policies and interventions targeting inequitable access to and use of supportive care medications are necessary to ensure pharmacoequity in cancer care.