Disparities in Time to Oral Antimyeloma Treatment Shown in New Study
Hamlet Gasoyan, MD, discusses what to know from a study that found there to be disparities in time to treatment with oral antimyeloma medications when used in patients with newly diagnosed multiple myeloma.
Hamlet Gasoyan, MD, staff investigator at the Center for Value-Based Care Research in the Department of Internal Medicine of Cleveland Clinic’s Primary Care Institute and assistant professor of medicine at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, discusses what to know from a Cleveland Clinic study that found there to be disparities in time to treatment with oral antimyeloma medications when used in patients with newly diagnosed multiple myeloma.
Transcription:
0:09 | We found considerable discrepancy between the timing of oral medication fill in patients newly diagnosed with multiple myeloma compared [with] any treatment initiation, or even treatment initiation with either orally or facility administered treatment for multiple myeloma. In other words, patient had delayed fills for their orally administered medications, showing that there might be some administrative burden for them and we knew that then, that is pretty much why we looked at this study, that getting a prescription filled oral antimyeloma medication, particularly lenalidomide [Revlimid], is complex. Patients have to undergo a multistep process. For example, they and their providers have to complete the REM survey even before a prescription could be written. And then [sometimes], lenalidomide could be only filled in specialty pharmacies. It is very expensive, so many patients would need to apply for grants, financial assistance grants, to be able to pay for their out-of-pocket costs, and also, there is an insurance authorization process which also could post a burden.
1:36 | What we found in our study was that the timing of getting any treatment for multiple myeloma, which also included cheaper corticosteroids, was much shorter than getting your prescription filled for lenalidomide, which is part of most commonly administered triplet or quadruplet regimens for patients with newly diagnosed, undiagnosed multiple myeloma and part of a standard-of-care. We also found some independent predictors associated with no prescription fill for oral antimyeloma medication for 30 days. Those predictors included older age, Black race, diagnosis during an inpatient stay, and then also an EGFR, or estimated glomerular filtration rate of less than 29 compared [with] over 60.
