Patients with multiple myeloma (MM) who are exposed to double-class or triple-class treatments for the disease are likely to face a high financial burden for care, according to research published in the Journal of Managed Care & Specialty Pharmacy.

The advent of immunomodulatory drugs and proteasome inhibitors has helped to improve survival, but patients require long-term care, which can both reduce quality of life and become financially toxic, particularly for patients treated in the US.

Although it’s known that MM is linked with a high rate of health care resource utilization and costs, particularly among newly diagnosed and heavily pretreated patients, the economic burden among patients who are double-class- or triple-class-exposed (DCE and TCE, respectively) was previously unestablished.

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For this retrospective cohort study, researchers analyzed data obtained from IBM MarketScan databases to measure the economic burden of care in these groups of patients with MM.

Overall, data from 1521 patients were included, among whom 1016 were DCE and 505 were TCE. In the overall cohort, at baseline, 57% of patients were male sex, the mean age was 62.3 years, 66.7% of patients had commercial insurance, 32.3% of patients were covered by Medicare, and 932 patients had received both an immunomodulatory drug and a proteasome inhibitor.

Analyses were conducted for baseline and follow-up periods. During the baseline period, the mean total all-cause health care costs were $29,849 (95% CI, $28,673-$31,026) per patient per month; 81% of these costs, furthermore, related to MM.

The mean follow-up was 16.3 months. At this point, analysis suggested that the mean total all-cause health care costs were $20,338 (95% CI, $19,384-$20,956), of which 85% were related to MM. The costs of patients in the DCE cohort (mean, $17,171) were, furthermore, lower than for patients in the TCE cohort ($29,791).

“The study findings suggest that the economic burden following exposure to multiple drug classes and combinations is substantial, especially among the TCE patients and in ambulatory and inpatient settings,” the authors noted in their report.

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, or device companies. Please see the original reference for a full list of disclosures.


Yang J, Boytsov N, Carlson JJ, Barthold D. Health care resource utilization and costs among patients with multiple myeloma with exposure to double-class or triple-class multiple myeloma treatments: A retrospective US claims database analysis. J Manag Care Spec Pharm. 2023;29(8):917-926. doi:10.18553/jmcp.2023.29.8.917