Oral Multiple Myeloma Medication Linked to Decreased Productivity Loss

Chase Doyle

February 2018, Vol 9, No 1 | Payers’ Perspectives In Oncology: ASH 2017 Highlights - Multiple Myeloma, Value-Based Care

Atlanta, GA—A recent analysis of a commercial claims database suggests that oral therapy for multiple myeloma may help decrease the economic burden for patients and healthcare systems. According to data presented at ASH 2017, patients with multiple myeloma who received injectable therapy used significantly more disability benefits and incurred higher productivity costs than patients who received oral medications.

“The use of novel multiple myeloma drugs has been associated with improved therapeutic outcomes and survival, but the disease continues to pose a significant economic burden. Evaluating the economic implications and outcomes of available treatments is important to improve efficiency of care,” said David Merola, PharmD candidate, Bernard J. Dunn School of Pharmacy, Shenandoah University, Winchester, VA.

Productivity loss is common in patients with multiple myeloma, including lost days from work or inability to work because of symptoms or treatment, Mr Merola explained. Although the direct costs of illness have been well-described in the literature, he noted, the indirect costs associated with multiple myeloma are understudied.

For this study, Mr Merola and colleagues analyzed the extent of workplace productivity loss in the United States among adults with multiple myeloma and its associated costs. These outcomes were compared among patients who received injectable versus oral multiple myeloma therapy. Mr Merola and colleagues used the Truven Health Analytics MarketScan Commercial Claims and Encounters with Medicare Supplemental Coordination of Benefits and Health and Productivity Management databases. Patients aged ≥18 years who were diagnosed with multiple myeloma between January 1, 2008, and December 31, 2014, were included in the study and were followed until December 31, 2015. The patients were analyzed 1 year before and 1 year after their first diagnosis.

Mr Merola and colleagues evaluated productivity loss using several key variables found in workplace absenteeism, short-term disability, and long-term disability claim files. The cost of productivity loss was calculated for each patient by multiplying the number of days lost to absenteeism by the average daily wage for all occupations in accordance with the US Bureau of Labor Statistics.

Fewer Workdays Missed

The study included 299 patients with newly diagnosed multiple myeloma; 73 patients received oral therapy and 226 received injectable agents. A regression analysis showed that treatment type was a significant predictor of productivity loss. Patients who received injectable therapy missed an average of 110 workdays in the 1 year postdiagnosis compared with 87 days (P <.001) for patients receiving only oral therapy. Treatment type was also a significant predictor of the cost of lost productivity. The lost productivity cost was $18,315 for patients who received injectable therapy and $14,429 for patients who only received oral drug therapy. The difference in valuated productivity losses between the study groups was also statistically significant at $3886 (P <.001).

According to Mr Merola and colleagues, an interrupted time-series analysis showed a significant increase in missed workdays per month after the initial diagnosis of multiple myeloma for both treatment groups. Patients who received injectable therapy experienced an immediate increase of 6.9 lost productivity days per month (P <.001) compared with 4.4 days per month in patients who received oral therapy alone (P <.001). The difference in these values was not statistically significant, said Mr Merola, although a strong trend was observed (2.5 days per month; P = .057).

Further studies are needed to elucidate the differences in outcome between patients receiving oral and injectable chemotherapies, Mr Merola and colleagues concluded.