Adherence to oral oncolytic medications significantly improved for patients with high digital engagement during the pandemic, according to findings presented at AMCP 2023.

“COVID-19 has substantially decreased cancer screening, management visits and surgeries,” researchers said. “This study examined the impact of COVID-19 on adherence to oral oncolytic agents in a large health plan with a significant digital health platform.”

The retrospective cohort study was conducted among adult patients who initiated medications for chronic myelogenous leukemia, ovarian cancer, or prostate cancer from March 2019 to March 2021. Researchers defined preCOVID-19 initiators as those who started medications before March 1, 2020, and COVID-19 initiators as those who began therapy after March 1, 2020, with at least 1 year of follow-up.

The cohort included 15,494 patients. Of these, 8,067 (52.07%) were preCOVID-19 initiators, who were less likely than COVID-19 initiators to be male (75.32% vs 77.34%; P < .01) and receive copay assistance (38.37% vs 41.70%; P < .01), according to the findings. 

Researchers found no statistically significant difference in digital engagement before and during COVID-19 (74.55% vs 73.60%; P = .18).

Optimal adherence was less likely among preCOVID-19 initiators compared to COVID-19 initiators (84.75% vs 85.96%; P = .04). COVID-19 initiators also had higher rates of therapy persistence, with a greater number of prescription fills (Median [quartile (Q) Q1-Q3]: 10 [4-12] vs 9[4-12]; P < .01) and fewer therapy changes (8.87% vs 9.95%; P = .02).

Initiating oral oncolytics during COVID-19 was not associated with optimal adherence (odds ratio (OR) = 1.06 [95% (confidence interval (CI) 0.96 to 1.16]). 

However, researchers identified a positive relationship between adherence to oral oncolytics and digital engagement rates. The odds of adherence were 0.64 (95% CI 0.56 to 0.72) in patients with low digital engagement, 0.67 (95% CI 0.56 to 0.76) in patients with moderate engagement, and 1.71 (95% CI 1.48 to 1.99) in patients with high engagement.

“Other factors associated with increased adherence were copay assistance, male gender, and age between 65 and 84 (all P < .05),” researchers reported.

Meanwhile, decreased adherence was more common in patients who switched therapies, had chronic myeloid leukemia, and were younger than 50 years of age (all P < .05).

“Patients with high digital engagement during the pandemic experienced significantly improved adherence. Persistence and number of fills were slightly improved in COVID-19 initiators, suggesting that the current pandemic may have influenced adherence behaviors,” the researchers advised.

CVS Health sponsored the study.

Reference:
Avalos-Reyes E, McAuliff K, Rutter WC, et al. Impact of COVID-19 on oral oncolytic adherence. J Manag Care Spec Pharm. 2023;29(10-a suppl):S1-S137. https://www.jmcp.org/pb-assets/Poster%20Abstract%20Supplements/AMCP2023_PosterAbstractSupplement_0317-1679318682267.pdf