Study Shows Disparities in Access to Care for Patients with Multiple Myeloma

A new study out of France found that patients with multiple myeloma (MM) who lived closer to the hospital in smaller and richer cities were more frequently treated with injectable chemotherapy.

“These results suggest that organizational interventions could help reducing the observed disparities in access to hospital-at-home facilities,” wrote Ulysse Rodts, of KanopyMed, Clapiers, France, who presented the data at the European Hematology Association (EHA) 2021 Virtual Annual Meeting.

According to the authors, there are a lack of data about the real-world management of patients with MM in France and factors that influence patients’ orientation and use of different hospital care facilities.

With this retrospective study, Rodts and colleagues wanted to describe access to chemotherapy injection for MM. They looked at data from 12,493 patients who received at least one chemotherapy injection in France in 2018. Of these, 3,625 had all necessary data and were treated in a center offering hospital-at-home chemotherapy.

About one-third of the patients (32.6%) had at least one chemotherapy injection delivered in the hospital-at-home setting. The average age of these patients was 68 years.

On average these patients lived about 26 kilometers from the hospital. The average size of the city of residence was 51,283 inhabitants, with a median annual income of €22,702. The majority of patients received bortezomib (60.5%); fewer received carfilzomib (7%).

The researchers calculated the probability of receiving at least one chemotherapy injection in the hospital-at-home setting and found it to be higher for patients treated by bortezomib (odds ratio=21.3; 95% CI, 16.4-28.2) and those living in more affluent cities (OR=1.07; 95% CI, 1.05-1.09). The probability was significantly lower for patients living further from the hospital (OR=0.99; 95% CI, 0.98-1.00) and in larger cities (OR=0.98; 95% CI, 0.97-0.98).