A new study from the Cleveland Clinic has uncovered significant disparities in the time it takes for patients with newly diagnosed multiple myeloma to begin oral antimyeloma treatment. The research, published in Blood Cancer Journal, reveals that patients often experience considerable delays in filling prescriptions for oral medications compared to the initiation of any myeloma treatment, including facility-administered therapies.
The study points to several factors contributing to these delays. According to Dr. Hamlet Gasoyan, a staff investigator at the Cleveland Clinic and assistant professor at Case Western Reserve University, the process of obtaining oral antimyeloma medications, particularly lenalidomide, is complex and can be administratively burdensome. This includes the requirement for patients and providers to complete the REMS survey before a prescription can be written, the limited availability of lenalidomide through specialty pharmacies, the high cost of the medication, and the need for insurance authorization.
The research team found that the time to initiate any treatment for multiple myeloma, including cheaper corticosteroids, was significantly shorter than the time to fill prescriptions for lenalidomide, a key component of standard triplet or quadruplet regimens. Furthermore, the study identified several independent predictors associated with a delay of 30 days or more in filling oral antimyeloma prescriptions. These included older age, Black race, diagnosis during an inpatient stay, and an estimated glomerular filtration rate (EGFR) of less than 29 compared to over 60.
"We found considerable discrepancy between the timing of oral medication fill in patients newly diagnosed with multiple myeloma compared with any treatment initiation," Dr. Gasoyan explained. He also noted that the study's findings highlight the need to address these disparities and streamline the process of accessing oral antimyeloma medications for all patients.
The findings underscore the importance of addressing administrative and financial barriers to ensure timely access to essential oral therapies for multiple myeloma patients. Further research and interventions are needed to mitigate these disparities and improve patient outcomes.
