{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T02:57:22Z","timestamp":1791341842613,"version":"4.3.1"},"reference-count":53,"publisher":"American Society of Clinical Oncology (ASCO)","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncol Pract"],"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>To examine whether Medicare Advantage (MA) enrollment is associated with differences in the timeliness of novel hormonal therapy (NHT) initiation, including abiraterone, enzalutamide, apalutamide, and darolutamide, for metastatic hormone-sensitive prostate cancer (mHSPC), compared with Traditional Medicare (TM), and to explore disparities by race, socioeconomic status (SES), and care setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using the Flatiron Health Research Database, including 3,215 patients age \u226565 years diagnosed with mHSPC between 2018 and 2023. Timely NHT initiation was defined as receipt within 45 days of diagnosis. Multivariable logistic regression models were adjusted for age, race\/ethnicity, year of diagnosis, de novo metastatic status, Eastern Cooperative Oncology Group performance status, SES, and practice type, using inverse probability of treatment weighting to balance baseline characteristics between MA and TM groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Among the 3,215 patients, 2,011 (63%) were enrolled in TM and 1,204 (37%) in MA. Overall, 25% initiated NHT within 45 days of diagnosis. Compared with TM beneficiaries, MA enrollees was associated with lower odds of timely NHT initiation (adjusted odds ratio [aOR], 0.82 [95% CI, 0.70 to 0.95];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .01). Differences were more pronounced among racial and ethnic minority patients (aOR, 0.54 [95% CI, 0.37 to 0.77]), individuals from lower-SES areas (aOR, 0.75 [95% CI, 0.58 to 0.98]), and patients receiving care in community settings (aOR, 0.80 [95% CI, 0.67 to 0.95]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>MA enrollment was associated with lower odds of timely NHT initiation compared with TM. These associations were particularly evident among underserved groups, highlighting the need to evaluate how MA program structures may influence equitable access to evidence-based cancer care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/op-25-00465","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T19:59:46Z","timestamp":1776974386000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":1,"title":["Insurance Disparity in Novel Hormonal Therapy Initiation in Patients With Metastatic Hormone-Sensitive Prostate Cancer: Medicare Advantage Versus Traditional Medicare"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3771-9877","authenticated-orcid":true,"given":"Baqir","family":"Jafry","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Charleston Area Medical Center\/West Virginia University, Charleston, WV"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7479-6803","authenticated-orcid":true,"given":"Chuan Angel","family":"Lu","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Ji","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Texas Southwestern Medical Center, Dallas, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1097-3300","authenticated-orcid":true,"given":"Xin","family":"Hu","sequence":"additional","affiliation":[{"name":"Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA"},{"name":"Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3462-376X","authenticated-orcid":true,"given":"Raj","family":"Bhanvadia","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Qin","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7159-7949","authenticated-orcid":true,"given":"Xuesong","family":"Han","sequence":"additional","affiliation":[{"name":"Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4577-3248","authenticated-orcid":true,"given":"Ryan D.","family":"Nipp","sequence":"additional","affiliation":[{"name":"Section of Hematology &amp; Oncology, Department of Medicine, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, Oklahoma City, OK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7290-3864","authenticated-orcid":true,"given":"Ya-Chen Tina","family":"Shih","sequence":"additional","affiliation":[{"name":"Program in Cancer Health Economics Research, Jonsson Comprehensive Cancer Center, and Department of Radiation Oncology, School of Medicine, University of California, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0644-5572","authenticated-orcid":true,"given":"K. 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