Myeloma patients who receive benefits but no low-income subsidies are not able to easily afford oral anticancer therapy, according to a study involving more than 3,000 individuals.

Investigators looked at how low-income subsidies impacted use of oral immunomodulatory drugs (IMiDs) and costs in Medicare patients diagnosed with myeloma between 2007 and 2011. Among the results:

• 4 in every 10 beneficiaries received first-line IMiDs.
• Median out-of-pocket cost for the first IMiD prescription was nearly $3,200 for patients who received no subsidy, vs $3 for those who did.
• Median costs for year 1 therapy was more than $5,600 and $6, respectively.
• Patients 75 to 84 years of age who received a subsidy were 32% more likely to receive IMiDs.
• Duration of therapy was a median of 7.6 months overall, and did not significantly differ between the 2 income groups.
• Patients treated with IMiDs had significantly fewer emergency department visits than those not treated with such, but overall survival and cumulative Medicare costs were similar.