[LarryD]

New study about self-administering Velcade at home

by LarryD on Sat Jan 09, 2016 9:07 am

The French myeloma group has just published the results of a study about self-administration of subcutaneous injections of Velcade (bortezomib) at home. They find that "Home administration of s.c. bortezomib is cost-effective and is preferred by myeloma patients compared with hospital administration."

Here is the full abstract:

Background: Subcutaneous (s.c.) administration of bortezomib is the most widely used route of administration for the treatment of patients with multiple myeloma. No study has as yet prospectively evaluated home versus hospital administration of s.c. bortezomib with respect to patient preference and cost.

Patients and methods: In this prospective trial, myeloma patients received the first administration of s.c. bortezomib of each cycle in the outpatient unit of the Department of Hematology. When possible, all subsequent doses of bortezomib within each cycle were provided at home. A cost analysis was carried out to compare the average cost of an injection of bortezomib in the outpatient unit and at home. In order to compare hospital and home administration of bortezomib for preference and satisfaction, patients had to complete 2 simple questionnaires analyzing 16 criteria, such as quality of life, well-being, social life, satisfaction, safety, quality of care, the reduction in personal transportation time, and personal anxiety. Each item was analyzed using a Likert scale.

Results: Fifty patients were studied. Overall, a total of 1043 s.c. injections of bortezomib were carried out, 655 (62.8%) at home, and 388 (35.2%) in the outpatient unit. The cost analysis showed that the total cost of one s.c. injection of bortezomib in the outpatient unit was €1510.09 versus €1224.57 for the home administration, which represents a reduction of €285.52, i.e. 20% of the cost of the hospital administration. The evaluation of patient preference and satisfaction showed that home administration improved the quality of life in 84% of the patients, increased well-being in 78%, and improved the activities of daily living in 72% of the cases. Overall, 98% of the patients noted their preference for home administration over the hospital administration of bortezomib.

Conclusion: Home administration of s.c. bortezomib is cost-effective and is preferred by myeloma patients compared with hospital administration.

And here is the complete reference:

A Lassalle et al, "Home administration of bortezomib in multiple myeloma is cost-effective and is preferred by patients compared with hospital administration: results of a prospective single-center study," Annals of Oncology, November 2015 (abstract)

--Larry

[Little Monkey]

Re: New study about self-administering Velcade at home

by Little Monkey on Sat Jan 09, 2016 10:06 am

I don't think you will ever see Velcade being injected outside of a hospital here in Ontario. If it is injected in a hospital here, the law says it is free. At $1000 a vial, the government would hate to see it fall on the floor of a patient's kitchen. Further, there would be a slight risk of a vial of Velcade ending up on the black market.

If Velcade where to be given here outside of a hospital, who pays for it would be complex. For example, if you are recipient of ODSP or CCAC, it would be covered. If you have private medicine and dental insurance, it would be covered. If you have no private insurance, nor on ODSP/CCAC, then any prescription medicines are covered in Ontario if the cost exceeds 4% of your household income, the government divides your deductible into 4 for each 3 month period, complicated ...

What the cancer centres do here in Ontario is arrange your chemo to be given at the closest community hospital if possible.

[Cheryl G]

Re: New study about self-administering Velcade at home

by Cheryl G on Sat Jan 09, 2016 11:56 am

Thanks for posting this, Larry.

Newer members of the forum should know that there is at least one forum member who self-administers Velcade at home with the approval of his doctor and his insurance. He discusses how he does it in this forum thread:

"Self-injecting Velcade - my experience" (started Aug 17, 2014)

So it is possible, and I personally feel it's something that more doctors should be encouraging their patients to do -- particularly after the initial cycle or so of Velcade treatment. Physicians don't have a problem with their patients self-administering Revlimid, Pomalyst, and thalidomide at home, even though those drugs can cause side effects such as low blood counts. And self-injection is common for a wide range of medications, starting with something as basic as insulin.

[Beacon Staff]

Re: New study about self-administering Velcade at home

by Beacon Staff on Sun Jan 10, 2016 9:00 am

A study has been published about Velcade self-administration at home. See this forum thread for a discussion of it:

"New study about self-administering Velcade at home"