The Impact of Patient Support Program Participation on Treatment Compliance for Patients Initiating Ibrutinib

Introduction:
Oral oncolytics offer advantages over chemotherapy, but oncology patients may face treatment compliance challenges. Previous studies have shown patient support programs (PSPs) can improve treatment compliance. Imbruvica “By Your Side” (BYS) PSP nurse ambassadors educate and advise patients to help optimize access and treatment outcomes. This study specifically examined the impact of BYS on enrollee persistence with ibrutinib treatment, as compared with commercially insured non-enrollees, with persistence further stratified by race/ethnicity.
Methods:
BYS electronic health record and linked Symphony Health (SH) all-payer open-source administrative claims data (1/15/2021–5/31/2022) were used to identify commercially insured adults with ≥1 final approved ibrutinib pharmacy claim (first claim after January 15, 2021 [BYS start date ± 30 days] = index date); patients were required to have medical claims activity (≥1 claim) for ≥6 months and pharmacy claims activity (≥1 claim) for ≥3 months prior to index date. Patient baseline demographics and comorbidity burden and ibrutinib treatment persistence (no refill gaps of ≥60 days) at 3, 6, and 9 months post-index date were assessed. Unadjusted persistence was further assessed by patient race/ethnicity (Black, Non-Hispanic White, Hispanic, and other). Treatment persistence was compared between BYS enrollees and non-enrollees (non-BYS) using multivariable analyses adjusted for demographics and comorbidities.
Results:
The total study population comprised: a 3-month cohort (index date before 2/28/2022): BYS n=547, non-BYS n=643; a 6-month cohort (index date before 11/30/2021): BYS n=451, non-BYS n=539; and a 9-month cohort (index date before 08/30/2021): BYS n=351, non-BYS n=410. Compared with non-BYS patients, BYS enrollees were younger (mean age 63.4 vs 65.4‚Äâyears; pDiscussion:
We identified BYS enrollment as a significant predictor of ibrutinib treatment persistence at 3, 6, and 9 months. Unadjusted analysis stratified by race/ethnicity data also suggested an impact of BYS on persistence among Black and Hispanic patients, although the data were underpowered. Treatment persistence is critical for optimal treatment outcomes, and results align with previous findings indicating that PSP’s help extend treatment periods. Further investigation with larger race/ethnicity sample sizes and longer follow-up are warranted. As open-source claims data cannot capture continuous insurance enrollment, persistence across both cohorts may have been underestimated