A telemedicine-supported pilot program at Memorial Sloan Kettering Cancer Center showed that premenopausal breast cancer patients can successfully self-administer gonadotropin-releasing hormone agonist (GnRHa) injections — like leuprolide — at home, with high completion rates and strong satisfaction. Nurses trained participants in person, and optional telehealth check-ins were available for the first two home injections. Nearly all participants completed at least one home injection, and three-quarters continued doing so after the study ended.

The biggest roadblock wasn't medical — it was financial. Of 105 patients approached, 54 wanted to join, but only 24 could actually participate due to insurance denials, lengthy approval delays, or copays that jumped sharply when the drug shifted from a medical benefit (clinic-based) to a pharmacy benefit (home-based).

By the Numbers:

• 95.8% of participants completed at least one home injection
• 79.2% completed two injections
• 75% continued home administration after the pilot ended
• 88.2% cited time savings and scheduling control as top benefits
• 50%+ of interested patients were blocked by insurance barriers; copays ranged from $3 to $2,000

Why it matters: Home injection could meaningfully cut the treatment burden for breast cancer patients who need monthly injections for years — but without policy fixes to align reimbursement across care settings, this innovation risks being available only to those who can afford it.