Home Leuprolide Injections Feasible for Breast Cancer Care

A telemedicine-supported home-injection program for women with breast cancer receiving intramuscular leuprolide, a gonadotropin-releasing hormone agonist (GnRHa), was feasible and acceptable in a small quality-improvement study published in JAMA Network Open.

The program enrolled adults receiving ongoing leuprolide therapy at four outpatient medical oncology practices within a comprehensive cancer center. Participants received in-clinic training on medication preparation and administration. Optional telemedicine visits with nursing staff were available to provide real-time instruction or supervision for as many as two home injections during the 6-month pilot.

Among 24 women who entered the pilot, 23 (95.8%) completed at least one home injection, 19 (79.2%) completed two injections, and 18 (75.0%) continued home administration after the study. Patient and clinician net promoter scores were 69 and 61, respectively. Participants most frequently cited time savings, greater control over scheduling, and convenience as benefits.

Insurance coverage was a substantial implementation barrier. Of 54 patients interested in participating, 19 (35.2%) could not proceed because home administration was not approved by their insurers. Among 30 patients who received authorization, 18 (60.0%) incurred a copayment when leuprolide coverage shifted from the medical benefit for clinic administration to the pharmacy benefit for home administration. Six patients declined participation after learning about the associated out-of-pocket costs.

The investigators concluded that telemedicine-supported home administration was feasible for selected patients, but insurance and cost barriers would need to be addressed before the model could be scaled. The findings were limited by the 24-patient sample, four-practice setting, and relatively homogeneous participant population. The study did not directly compare home and clinic delivery or evaluate comparative clinical and safety outcomes.

Source: Malling CD, Bange EM, Reiner AS, et al. A telemedicine-supported home-injection model for patients with breast cancer. JAMA Netw Open. 2026;9(8):e2629406. doi:10.1001/jamanetworkopen.2026.29406