Patients with multiple myeloma (MM) initiated intravenous (IV) and oral therapies at an increased rate after the COVID-19 pandemic began, which researchers say may be attributable to a significant decrease in the number of newly diagnosed patients. 

“COVID-19 has impacted several areas of oncology patient care, most notably the reduction of patient visits for treatments,” researchers said. “The purpose of this study is to assess the impact COVID-19 had on IV and oral medication prescribing patterns pre and during the COVID-19 pandemic.”

For the retrospective study, researchers used medical and pharmacy claims data to identify 1754 adult patients with MM who started a new intravenous (IV) or oral therapy during the study period. Patients were insured through a large Medicare and commercial health plan. To measure the impact of COVID-19, researchers studied MM therapy prescribing patterns before COVID-19 (March 1, 2019, to August 31, 2019) and during COVID-19 (March 1, 2020, to August 31, 2020.

“We calculated new therapy starts per newly diagnosed patient (defined as the number of patients starting a new IV or oral medication for MM divided by the total number of patients with a first indication date of MM within the study timeframe),” explained researchers. “We compared rates using a Chi-square test; P-values ≤ 0.05 were considered statistically significant.” 

There were no statistically significant differences in patient age (67.05 vs 66.64; P = .45), gender (P = .80), insurance plan type (P = .17), geographical region (P = .26) and medication (P = .59) before and during the pandemic. Insurance type also was not associated with start rate differences (all P > .08).

During the pandemic, the number of patients initiating therapy decreased by 11% (930 to 824) and the number of newly diagnosed patients declined by 22% (9657 to 7560) compared to prepandemic rates. 

Additionally, newly diagnosed patients had increased rates of starting new IV (11%; P = .03) and oral (51%; P = .03) therapies. Patients in the Northeast had significant increases in starting oral therapy (157%; P < .01), while patients in the West increasingly initiated IV agents (32%; P = .02).

“While the total count of new therapy starts, a proxy for new diagnoses, decreased during COVID-19, the rate of new starts for both IV and oral therapies for patients diagnosed with MM significantly increased. These increased start rates may be explained by a remarkable 22% drop in the total number of newly diagnosed MM patients during COVID-19,” researchers concluded.

The investigators recommended further studies to elucidate the impact of COVID-19 on IV and oral medication use among patients with MM.

Reference:
Avalos-Reyes E, Shah D, McAuliff K, et al. COVID-19 impact on multiple myeloma prescribing patterns. J Manag Care Spec Pharm. 2023;29(10-a suppl):S1-S137. https://www.jmcp.org/pb-assets/Poster%20Abstract%20Supplements/AMCP2023_PosterAbstractSupplement_0317-1679318682267.pdf