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When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
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Identifying health disparities in lenalidomide access.

Ngan N Nguyen1, Justin P Huynh1,2, Jenna J Wu1,2

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Lenalidomide prescriptions take a median of 8 days to fill. Patients needing financial assistance face longer delays, highlighting how insurance and health disparities impact access to this cancer drug.

Keywords:
Multiple myelomahealth disparitieslenalidomide

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Area of Science:

  • Oncology
  • Hematology
  • Health Services Research

Background:

  • Lenalidomide access is complicated by limited distribution, risk evaluation and mitigation strategies (REMS), and insurance hurdles.
  • Health disparities such as socioeconomic status, health literacy, language, and geography can impede timely lenalidomide acquisition.
  • Understanding these barriers is crucial for improving patient access to essential cancer therapies.

Purpose of the Study:

  • To identify and analyze factors contributing to delays in lenalidomide prescription fulfillment.
  • To examine lenalidomide access from a health equity perspective.
  • To determine the median time from prescription generation to lenalidomide dispensation.

Main Methods:

  • Retrospective study utilizing electronic health records from the Brown University Health system (June 2019 - June 2024).
  • Inclusion criteria: adults with new hematologic malignancies prescribed lenalidomide.
  • Stepwise multiple linear regression analysis to identify factors associated with dispensation time.

Main Results:

  • A total of 328 patients were analyzed (mean age 71 years; 53% male; 80% White).
  • Fifty-four percent of patients required financial assistance, which was significantly associated with delayed lenalidomide dispensation (P < 0.05).
  • The median time from prescription to dispensation was 8 days (IQR, 5-14 days).

Conclusions:

  • Lenalidomide prescriptions have a median fill time of 8 days.
  • Financial assistance requirements are linked to extended delays in lenalidomide access.
  • Insurance processes and existing health disparities significantly hinder timely access to lenalidomide for patients with hematologic malignancies.