COVID-19 impact on multiple myeloma prescribing

ABSTRACT

Background: COVID-19 has impacted several areas of oncology patient care, most notably the reduction of patient visits for treatments. Standard treatment of multiple myeloma (MM) involves a combination of intravenous (IV) and oral therapies. Objective(s) 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 among MM patients. Method(s) This is a retrospective review of adult MM patients insured by a large commercial and Medicare health plan in the United States who started a new IV or oral MM agent during the study period. To assess the impact of COVID-19 on IV and oral medication prescribing patterns, we compared a pre-COVID period (1 March-31 August 2019) to a COVID period (1 March-31 August 2020). We utilized medical and pharmacy claims to identify patients and 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). We compared rates using a Chi-square test;p-values <=.05 were considered statistically significant. Result(s) 1754 patients were enrolled in the study;there were no significant differences in demographic characteristics pre and during COVID-19 between the two groups with respect to age (67.05 vs. 66.64;p=.45), gender (p=.80), insurance plan type (p=.17), geographical region (p=.26) and medication (p=.59). During COVID-19, the number of newly diagnosed MM patients decreased by 22% (9657-7560) and the total number of new therapy starts decreased by 11% (930-824). When looking at rates of new therapy starts per newly diagnosed patient, both IV (11%;p=.03) and oral (51%;p=.03) medication rates significantly increased. Additionally, there were significant increases in new therapy start rates by region in the Northeast for oral (157%;p=.08). Conclusion(s) 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. As the pandemic continues, further study is warranted to understand how COVID-19 may impact IV vs. oral usage in MM.