Patients with sickle cell disease (SCD) receiving Medicare or Medicaid were found to have an estimated life expectancy from birth of 52.6 years, according to a recent study. Study results were reported in the journal Blood Advances.1

“Our study highlights that there is a persistent life expectancy gap among the individuals with sickle cell disease, even though they are covered by public insurance,” said lead study author, Dr Boshen Jiao, PhD, MPH, from the University of Washington in Seattle, in a news release. “The clinical community has known that SCD can be an extremely burdensome condition, however, this study puts numbers behind that burden using real patient data.”2

The retrospective study examined a nationwide cohort of US patients with SCD with Medicare or Medicaid claims data during the years of 2008 through 2016. Patients were receiving Common Care, or any type of real-world care excluding transplantation. Dr Jiao and colleagues examined lifetime survival probabilities and estimated life expectancies across multiple ages for all patients and with stratification by sex and type of insurance. Death certificates from the National Death Index were used to identify dates of death.1

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The study included 94,616 patients, and the researchers found that this population had a life expectancy at birth of 52.6 years (95% CI, 51.9-53.4). For females, the life expectancy at birth was 55.0 years (95% CI, 54.1-56.1), and for males it was 49.3 years (95% CI, 48.2-50.4).1

This contrasts with reported estimates in the US of life expectancies of 73.5 years on average for men and 79.3 years on average for women, highlighting the burden of disease faced by patients with SCD.2

Among patients with SCD, slight differences in life expectancy estimates could be seen by insurance type and other conditions. Life expectancies were shorter for adults who had Medicare coverage for disabilities or end-stage renal disease, compared with adults who had Medicaid coverage only. Those eligible for both Medicare and Medicaid also had shorter life expectancies compared with individuals having Medicaid coverage only.Among patients 65 years of age or older, life expectancies were shorter for patients who had Medicare for disabilities or end-stage renal disease, or who were eligible for both Medicaid and Medicare, compared with patients on Medicare old age and survivor’s insurance.1

Black patients with SCD had a life expectancy at birth of 52.2 years (95% CI, 51.4-53.1), compared with 55.1 years (95% CI, 53.2-57.0) for non-Black individuals with SCD. In comparison, the authors reported that the 2016 US Centers for Disease Control and Prevention life table had estimated a 75-year life expectancy for the general Black population.

“Our findings highlight the persistent life expectancy gap for SCD patients and the enduring premature mortality throughout adulthood,” the study authors concluded in their report. “This gap has improved little in recent decades.”

References

  1. Jiao B, Johnson KM, Ramsey SD, Bender MA, Devine B, Basu A. Long-term survival with sickle cell disease: a nationwide cohort study of Medicare and Medicaid beneficiaries. Blood Adv. Published March 16, 2023. doi:10.1182/bloodadvances.2022009202
  2. New study reveals average life expectancy of publicly insured individuals with sickle cell disease, drawing from massive public database. News release. American Society of Hematology. March 16, 2023. Accessed March 16, 2023. https://www.hematology.org/newsroom/press-releases/2023/quantifying-the-life-expectancy-gap-for-people-living-with-sickle-cell-disease

Topics:

Anemias Health Disparity Sickle Cell Disease