{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T21:35:07Z","timestamp":1791408907653,"version":"4.3.3"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T00:00:00Z","timestamp":1724371200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T00:00:00Z","timestamp":1724371200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000054","name":"U.S. Department of Health & Human Services | NIH | National Cancer Institute","doi-asserted-by":"publisher","award":["R00CA277136"],"award-info":[{"award-number":["R00CA277136"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Blood Cancer J."],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This retrospective cohort study used Taussig Cancer Center\u2019s Myeloma Patient Registry to identify adults with multiple myeloma diagnosed between January 2017-December 2021. Electronic health records data captured time from diagnosis to initial prescription fill for oral antimyeloma medications and initiation of facility administered or oral antimyeloma treatment. We identified 720 patients with a mean age at diagnosis of 67 years \u00b111; 55% were male, 77% White, 22% Black, 1% other races, covered by private insurance (36%), traditional Medicare (29%), Medicare Advantage (25%), and Medicaid (8.3%). Over a third of patients (37%) resided in an area in the most disadvantaged area deprivation index (ADI) quartile. The median available follow-up was 765 days. Seventy-five percent of the cohort filled an oral antimyeloma medication prescription (excluding corticosteroids), with a median time to fill of 28 days (IQR, 15\u201361). In the multivariable Cox regression model, Black race (vs. White, adjusted hazard ratio [aHR], 0.61, 95% CI, 0.42\u20130.87), older age at diagnosis (aHR per 1 year, 0.97, 95% CI, 0.95\u20130.98), diagnosis during an inpatient admission (aHR, 0.63, 95% CI, 0.43\u20130.92), and estimated glomerular filtration rate \u226429\u2009ml\/min\/1.73 m<jats:sup>2<\/jats:sup> (vs. \u226560, aHR, 0.46, 95% CI, 0.29\u20130.73) were negatively associated with prescription fill for oral antimyeloma medication at 30 days, while insurance type and ADI were not significant predictors.<\/jats:p>","DOI":"10.1038\/s41408-024-01128-1","type":"journal-article","created":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T21:15:48Z","timestamp":1724447748000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Disparities in time to treatment with oral antimyeloma medications"],"prefix":"10.1038","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1627-9777","authenticated-orcid":false,"given":"Hamlet","family":"Gasoyan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6914-7439","authenticated-orcid":false,"given":"Faiz","family":"Anwer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey D.","family":"Kovach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2291-835X","authenticated-orcid":false,"given":"Nicholas J.","family":"Casacchia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9977-7041","authenticated-orcid":false,"given":"Ming","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Valent","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8514-6313","authenticated-orcid":false,"given":"Michael T.","family":"Halpern","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael B.","family":"Rothberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,8,23]]},"reference":[{"key":"1128_CR1","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1007\/s40265-017-0689-1","volume":"77","author":"SA Holstein","year":"2017","unstructured":"Holstein SA, McCarthy PL. Immunomodulatory drugs in multiple myeloma: mechanisms of action and clinical experience. Drugs. 2017;77:505\u201320.","journal-title":"Drugs"},{"key":"1128_CR2","doi-asserted-by":"publisher","first-page":"e231090","DOI":"10.1001\/jamahealthforum.2023.1090","volume":"4","author":"MJ DiStefano","year":"2023","unstructured":"DiStefano MJ, Kang SY, Parasrampuria S, Anderson GF. Comparison of out-of-pocket spending on ultra-expensive drugs in medicare part D vs commercial insurance. JAMA Health Forum. 2023;4:e231090.","journal-title":"JAMA Health Forum"},{"key":"1128_CR3","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1182\/blood-2023-174451","volume":"142","author":"M Djulbegovic","year":"2023","unstructured":"Djulbegovic M, Doherty M, Fanslau K, Chen K, Girgis S, Joslyn P, et al. A randomized controlled trial of a financial navigation program for patients with multiple myeloma. Blood. 2023;142:909.","journal-title":"Blood"},{"key":"1128_CR4","doi-asserted-by":"publisher","first-page":"e420","DOI":"10.1016\/j.clml.2023.08.008","volume":"23","author":"H Gasoyan","year":"2023","unstructured":"Gasoyan H, Fiala MA, Doering M, Vij R, Halpern M, Colditz GA. Disparities in multiple myeloma treatment patterns in the United States: a systematic review. Clin Lymphoma Myeloma Leuk. 2023;23:e420\u2013e427. S2152265023002550","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"1128_CR5","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1200\/OP.23.00205","volume":"20","author":"MRL Lichtenstein","year":"2024","unstructured":"Lichtenstein MRL, Beauchemin MP, Raghunathan R, Lee S, Doshi SD, Law C, et al. Association between copayment assistance, insurance type, prior authorization, and time to receipt of oral anticancer drugs. JCO Oncol Pr. 2024;20:85\u201392.","journal-title":"JCO Oncol Pr"},{"key":"1128_CR6","doi-asserted-by":"publisher","first-page":"1925","DOI":"10.1182\/blood-2021-152085","volume":"138","author":"JS Pai","year":"2021","unstructured":"Pai JS, Patel R, Algaze S, Martinez L, Piatek CI. Improving delays in obtaining lenalidomide at a large safety net hospital. Blood. 2021;138:1925.","journal-title":"Blood"},{"key":"1128_CR7","doi-asserted-by":"publisher","first-page":"1064","DOI":"10.1002\/cncr.29160","volume":"121","author":"V Bhatnagar","year":"2015","unstructured":"Bhatnagar V, Wu Y, Goloubeva OG, Ruehle KT, Milliron TE, Harris CG, et al. Disparities in black and white patients with multiple myeloma referred for autologous hematopoietic transplantation: A single center study. Cancer. 2015;121:1064\u201370.","journal-title":"Cancer"},{"key":"1128_CR8","doi-asserted-by":"publisher","first-page":"2986","DOI":"10.1182\/bloodadvances.2019000308","volume":"3","author":"S Ailawadhi","year":"2019","unstructured":"Ailawadhi S, Parikh K, Abouzaid S, Zhou Z, Tang W, Clancy Z, et al. Racial disparities in treatment patterns and outcomes among patients with multiple myeloma: a SEER-Medicare analysis. Blood Adv. 2019;3:2986\u201394.","journal-title":"Blood Adv"},{"key":"1128_CR9","doi-asserted-by":"publisher","first-page":"5727","DOI":"10.21873\/anticanres.14587","volume":"40","author":"T Jayakrishnan","year":"2020","unstructured":"Jayakrishnan T, Bakalov V, Callander NS, Sadashiv S, Wagner R, Ailawadhi S. Impact of the affordable care act on timeliness to treatment for patients with multiple myeloma. Anticancer Res. 2020;40:5727\u201334.","journal-title":"Anticancer Res"},{"key":"1128_CR10","doi-asserted-by":"publisher","first-page":"e341","DOI":"10.1200\/JOP.19.00309","volume":"16","author":"V Kumar","year":"2020","unstructured":"Kumar V, Alhaj-Moustafa M, Bojanini L, Sher T, Roy V, Manochakian R, et al. Timeliness of initial therapy in multiple myeloma: trends and factors affecting patient care. JCO Oncol Pract. 2020;16:e341\u20139.","journal-title":"JCO Oncol Pract"},{"key":"1128_CR11","doi-asserted-by":"publisher","first-page":"2876","DOI":"10.1002\/cam4.1246","volume":"6","author":"S Ailawadhi","year":"2017","unstructured":"Ailawadhi S, Frank RD, Advani P, Swaika A, Temkit M, Menghani R, et al. Racial disparity in utilization of therapeutic modalities among multiple myeloma patients: a SEER-medicare analysis. Cancer Med. 2017;6:2876\u201385.","journal-title":"Cancer Med"},{"key":"1128_CR12","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.1016\/j.bbmt.2016.03.008","volume":"22","author":"VR Bhatt","year":"2016","unstructured":"Bhatt VR, Loberiza FR, Schmit-Pokorny K, Lee SJ. Time to insurance approval in private and public payers does not influence survival in patients who undergo hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2016;22:1117\u201324.","journal-title":"Biol Blood Marrow Transplant"},{"key":"1128_CR13","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1200\/EDBK_200869","volume":"38","author":"R Fonseca","year":"2018","unstructured":"Fonseca R, Hinkel J. Value and cost of myeloma therapy\u2014we can afford it. Am Soc Clin Oncol Educ Book. 2018;38:647\u201355.","journal-title":"Am Soc Clin Oncol Educ Book"},{"key":"1128_CR14","doi-asserted-by":"publisher","first-page":"1482","DOI":"10.18553\/jmcp.2021.27.10.1482","volume":"27","author":"S Blecker","year":"2021","unstructured":"Blecker S, Adhikari S, Zhang H, Dodson JA, Desai SM, Anzisi L, et al. Validation of EHR medication fill data obtained through electronic linkage with pharmacies. JMCP. 2021;27:1482\u20137.","journal-title":"JMCP"},{"key":"1128_CR15","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","volume":"61","author":"E von Elm","year":"2008","unstructured":"von Elm E, Altman DG, Egger M, Pocock SJ, G\u00f8tzsche PC, Vandenbroucke JP, et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61:344\u20139.","journal-title":"J Clin Epidemiol"},{"key":"1128_CR16","unstructured":"National Cancer Institute. Drugs Approved for Multiple Myeloma and Other Plasma Cell Neoplasms. 2023. https:\/\/www.cancer.gov\/about-cancer\/treatment\/drugs\/multiple-myeloma."},{"key":"1128_CR17","unstructured":"U.S. Department of Agriculture Economic Research Service. Rural-Urban Commuting Area Codes. 2020. https:\/\/www.ers.usda.gov\/data-products\/rural-urban-commuting-area-codes\/."},{"key":"1128_CR18","doi-asserted-by":"publisher","first-page":"2456","DOI":"10.1056\/NEJMp1802313","volume":"378","author":"AJH Kind","year":"2018","unstructured":"Kind AJH, Buckingham WR. Making neighborhood-disadvantage metrics accessible\u2014the neighborhood atlas. N. Engl J Med. 2018;378:2456\u20138.","journal-title":"N. Engl J Med"},{"key":"1128_CR19","doi-asserted-by":"publisher","first-page":"e65","DOI":"10.1097\/MLR.0b013e318297429c","volume":"53","author":"SR Austin","year":"2015","unstructured":"Austin SR, Wong YN, Uzzo RG, Beck JR, Egleston BL. Why summary comorbidity measures such as the charlson comorbidity index and elixhauser score work. Med Care. 2015;53:e65\u201372.","journal-title":"Med Care"},{"key":"1128_CR20","doi-asserted-by":"publisher","first-page":"1737","DOI":"10.1056\/NEJMoa2102953","volume":"385","author":"LA Inker","year":"2021","unstructured":"Inker LA, Eneanya ND, Coresh J, Tighiouart H, Wang D, Sang Y, et al. New creatinine- and cystatin C\u2013based equations to estimate GFR without race. N. Engl J Med. 2021;385:1737\u201349.","journal-title":"N. Engl J Med"},{"key":"1128_CR21","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1200\/OP.23.00672","volume":"20","author":"H Gasoyan","year":"2024","unstructured":"Gasoyan H, Anwer F, Casacchia NJ, Kovach JD, Valent J, Wang M, et al. Role of patient characteristics and insurance type in newly diagnosed multiple myeloma care disparities. JCO Oncol Pr. 2024;20:699\u2013707.","journal-title":"JCO Oncol Pr"},{"key":"1128_CR22","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-10-20","volume":"10","author":"CA Bellera","year":"2010","unstructured":"Bellera CA, MacGrogan G, Debled M, De Lara CT, Brouste V, Mathoulin-P\u00e9lissier S. Variables with time-varying effects and the Cox model: Some statistical concepts illustrated with a prognostic factor study in breast cancer. BMC Med Res Methodol. 2010;10:20.","journal-title":"BMC Med Res Methodol"},{"key":"1128_CR23","doi-asserted-by":"publisher","first-page":"230","DOI":"10.6004\/jnccn.2017.0023","volume":"15","author":"SK Kumar","year":"2017","unstructured":"Kumar SK, Callander NS, Alsina M, Atanackovic D, Biermann JS, Chandler JC, et al. Multiple Myeloma, Version 3.2017, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2017;15:230\u201369.","journal-title":"J Natl Compr Canc Netw"},{"key":"1128_CR24","unstructured":"Cubanski J, Neuman T, Freed M KFF. Explaining the prescription drug provisions in the inflation reduction Act. 2023. https:\/\/www.kff.org\/medicare\/issue-brief\/explaining-the-prescription-drug-provisions-in-the-inflation-reduction-act\/."},{"key":"1128_CR25","unstructured":"Centers for Medicare & Medicaid Services. CMS Interoperability and Prior Authorization Final Rule CMS-0057-F. 2024. https:\/\/www.cms.gov\/newsroom\/fact-sheets\/cms-interoperability-and-prior-authorization-final-rule-cms-0057-f."},{"key":"1128_CR26","unstructured":"Durie BGM International Myeloma Foundation. 2022. First Generic Revlimid (lenalidomide) Launched. https:\/\/www.myeloma.org\/blog\/first-generic-revlimid-lenalidomide-launched#:~:text=The%20volume%2Dlimited%20selling%20of,21%2C%202021%3B%20and%20Dr."},{"key":"1128_CR27","doi-asserted-by":"publisher","first-page":"6641","DOI":"10.1200\/JCO.2023.41.16_suppl.6641","volume":"41","author":"H Gasoyan","year":"2023","unstructured":"Gasoyan H, Rothberg MB. The role of private insurance characteristics in the out-of-pocket costs of patients with multiple myeloma. JCO. 2023;41:6641.","journal-title":"JCO"},{"key":"1128_CR28","first-page":"1","volume":"317","author":"RA Cohen","year":"2018","unstructured":"Cohen RA, Zammitti EP. High-deductible health plan enrollment among adults aged 18-64 with employment-based insurance coverage. NCHS Data Brief. 2018;317:1\u20138.","journal-title":"NCHS Data Brief"}],"container-title":["Blood Cancer Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41408-024-01128-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41408-024-01128-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41408-024-01128-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T21:16:06Z","timestamp":1724447766000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41408-024-01128-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,23]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["1128"],"URL":"https:\/\/doi.org\/10.1038\/s41408-024-01128-1","relation":{},"ISSN":["2044-5385"],"issn-type":[{"value":"2044-5385","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,23]]},"assertion":[{"value":"13 May 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 August 2024","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 August 2024","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 August 2024","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Dr. Faiz Anwer has consulting relationship with Bristol Myers Squibb Foundation, Caribou Biosciences and received research funding (outside of this study) from Celgene (Inst), Acetylon Pharmaceuticals (Inst), Millennium (Inst), Astellas Pharma (Inst), AbbVie (Inst), Janssen (Inst), Bristol Myers Squibb (Inst), and Caribou Biosciences (Inst). Dr. Michael B. Rothberg has consulting relationship with Blue Cross Blue Shield Association. The other authors declare no conflicts of interest. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, National Cancer Institute.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"142"}}