A recent study compared out-of-pocket costs for multiple myeloma patients in the United States being treated with Velcade ^[1] (bortezomib), Revlimid ^[2] (lenalidomide), thalidomide ^[3] (Thalomid), or another chemotherapy or radiation therapy. The results were presented at the American Society of Hematology (ASH) Meeting on December 5.

This study looked at approximately 1,900 multiple myeloma patients who filed claims with a national health insurance company. Researchers looked at out-of-pocket costs for each patient for a period of one year after the start of a new course of treatment.

For the 1,900 patients, researchers identified 2,642 treatment courses. Most treatments fell into the other chemotherapy or radiation therapy category (66 percent), followed by thalidomide (21 percent), Velcade (9 percent), and Revlimid (3 percent).

The total out-of-pocket costs for the year after beginning treatment with Velcade averaged to $3,504, compared to $4,443 for patients being treated with thalidomide, $4,766 for patients receiving Revlimid, and $3,907 for all other myeloma patients.

Researchers also looked specifically at costs for Medicare patients. The difference in out-of-pocket expenses was greater among this group of patients, with Velcade patients paying $4,395, thalidomide patients paying $8,824, Revlimid patients paying $12,568, and patients using other treatments averaging payments of $4,757.

Despite differences in cost, some patients prefer oral drugs (i.e., Revlimid and thalidomide) over intravenous drugs (i.e., Velcade) due to the convenience of not needing to visit a doctor’s office for treatment.

Among the patients studied, however, the number of physician visits (in outpatient or office settings) were similar among the different treatment regimens. Patients on Revlimid made 57 visits during the year after treatment started, while patients on thalidomide made 63 visits, patients on Velcade made 66 visits, and patients on other regimens made 72 visits during the year.

Likewise, there were no differences between treatment groups in number of inpatient hospital stays or emergency room visits.

It is unclear from the discussion in the abstract whether the reported results are likely to be typical for all patients covered by health care plans in the U.S., or if they reflect the policies of the specific insurer whose data were used for the study.

Ultimately, patients should always consult with their physician regarding efficacy, side effects, convenience, and cost of various treatment options.

For more information, please see abstract 1366 ^[4] on the ASH meeting Web site.