Timely next-generation sequencing testing in patients with metastatic prostate cancer: A comparative analysis between Medicare Advantage and traditional Medicare.

• DOI: 10.1200/jco.2025.43.5_suppl.320
• Publication Date: 2025-02-18T14:35:11Z
• Authors: Jonathan Wenbin Ji; Baqir Jafry; Chuan Angel Lu; Raj Bhanvadia; Qian Qin; Joseph Vento; Kevin Dale Courtney; Jue Wang; Waddah Arafat; Daniel X. Yang; Suzanne Cole; Tian Zhang; Changchuan Jiang

320 Background: Next-Generation Sequencing (NGS) testing has become a cornerstone of personalized medicine in cancer care. With Medicare Advantage (MA) now covering nearly half all beneficiaries, understanding differences access to timely NGS between MA and Traditional (TM) is crucial, particularly given MA’s potential restrictions. This study aims evaluate the effectiveness plans on patients with metastatic prostate (mPCa). Methods: retrospective cohort was based Flatiron Health deidentified Database, comprising electronic health record-derived data from ~280 practices across US. Our included aged 65 or older, diagnosed mPCa since 2018, exclusively enrolled TM MA, either before within 90 days following diagnosis. We compared rates using three timeframes—45-, 90-, 180-days post-mPCa defined as any tissue liquid genomic resulted time frame interest. Multivariate logistic regression inverse probability treatment weighting used, adjusting for demographics, year diagnosis, practice setting, baseline ECOG score. Results: Among 1,582 (mean age: 75.9 ± 5.8) 2,749 75.4 5.8), significant proportions were community (MA: 78%, TM: 80%) characterized by being White 59%, 65%), 75 85 54%, 57%), having higher socioeconomic status (SES 4 5: MA: 40.3%, 47.5%), presenting de-novo 53%, 54%), better functional performance (ECOG 0 1: 70%, 69%). Since 8.8%, 14.5%, 18.8% 10%, 14.6%, 17.6% received at 45, 180 days, respectively. Notably, 63.4% 60.8% patients, respectively, did not have testing. After covariation, associated 26.2% (OR=0.74, 95%CI 0.59-0.92), 16% (OR=0.84, 0.7-1.01), 7.8% (OR=0.92, 0.78-1.09) lower chance receive 45 Conclusions: Patients are less likely TM. The high rate delayed no underscores disparities access, especially among patients. Policymakers should streamline approvals ensure timely, high-quality care beneficiaries.