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Observational Study
. 2025 Jun;21(15):1905-1918.
doi: 10.1080/14796694.2025.2504318. Epub 2025 May 21.

Multiple myeloma care, treatment patterns, and treatment durations in academic and community care settings

Natalie Boytsov  1 , Catherine B McGuiness  2 , Zifan Zhou  3 , Tianyao Huo  4 , Kathleen Montgomery  5 , Nirali Kotowsky  1 , Chi-Chang Chen  2
Affiliations
Observational Study

Multiple myeloma care, treatment patterns, and treatment durations in academic and community care settings

Natalie Boytsov et al. Future Oncol. 2025 Jun.

Abstract

Aim: Evaluate multiple myeloma (MM) treatment patterns, healthcare utilization (HCRU), and costs from academic and community settings.

Methods: This observational study linked US MM insurance claims (1 April 2017-30 June 2022) with provider affiliations to evaluate patient characteristics and treatment durations across patient cohorts defined by care setting of treatment (academic only, community only, mixed [both]), as well as treatment patterns, HCRU, and costs of care (e.g. treatment, office visits, hospitalization) in each setting.

Results: 3778 patients were included. By cohort (n = 530 academic; n = 1647 community), the community cohort was older with more comorbidities. Mixed-cohort patients (n = 1601) frequently initiated treatment at community centers and briefly shifted to academic centers for transplant. Among 3778 patients who received MM-related care, most claims were from the community setting. The academic setting had high rates of claims for proteasome inhibitors (56.3% of patients) and steroids (52.5%); the community setting had high rates for immunomodulatory drugs (75.1%) and steroids (85.0%). Stem cell transplant claims were more common for academic versus community (21.4%/7.3%). Treatment duration/time to next therapy were similar between cohorts. Costs were generally higher in the academic versus community settings.

Conclusion: Improved patient support is needed in community settings, where most MM care occurs.

Keywords: Hematologic/myeloma; outcomes research; real-world evidence; treatment patterns.

Plain language summary

Patients with a type of blood cancer called multiple myeloma (MM) face complex treatment journeys, and most patients require multiple treatments over time to control the disease. Patients can receive treatments in different care settings. An academic setting includes hospitals/healthcare centers that train doctors and medical students. A community setting includes non-academic hospitals and centers. To access different treatments, patients with MM often receive care in both settings. Research has shown that patients treated in academic settings tend to live longer than patients treated in community settings, but more research is needed to understand the reasons for this difference. The goal of this study was to determine if there were differences between patients who received MM treatments in academic versus community settings, examine the types of MM treatments given, the services received, and the costs in each setting. We found that patients received most of their MM care in the community setting. Patients who received all their MM treatments in a community setting were older, more likely to have multiple health complications, and less likely to participate in clinical trials. A specialized treatment called a stem cell transplant was more frequently given in the academic setting, and patients often moved between settings to receive this treatment. In both settings, patients were often treated with the same drug more than once, which could reduce its effectiveness. Costs overall were higher in the academic setting. These findings show a need for new treatments that are available in both academic and community settings.

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Conflict of interest statement

Natalie Boytsov is an employee of and holds financial equities in GSK; Catherine B. McGuiness is an employee of IQVIA; Zifan Zhou is an employee of IQVIA; Tianyao Huo is an employee of IQVIA; Kathleen Montgomery is an employee of and holds financial equities in GSK; Nirali Kotowsky is a former employee of and held financial equities in GSK; Chi-Chang Chen is an employee of IQVIA. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Figures

Figure 1.
Figure 1.
Shifts in care in the mixed care cohort.
Figure 2.
Figure 2.
Percentage of patients with claims by MM therapeutic classes from the academic setting, community setting, and physicians with dual affiliations (A), and retreatment with same drug by drug class (B).
Figure 3.
Figure 3.
Care setting cohorts, lines of therapy and duration of therapy: (A) total number of therapy lines and (B) Kaplan–Meier-estimated treatment duration by line of therapy.
Figure 4.
Figure 4.
Care setting cohorts, time to next line of therapy: (a) Kaplan–Meier-estimated time to next line of therapy in patients who received at least 2 lines, and (b) Kaplan–Meier-estimated time from first to second line of therapy.
Figure 5.
Figure 5.
Percentage of patients with MM-related HCRU (a) and costs per claim (b) from academic and community settings (N = 3778).
See this image and copyright information in PMC

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References

    1. Puertas B, González-Calle V, Sobejano-Fuertes E, et al. Novel agents as main drivers for continued improvement in survival in multiple myeloma. Cancers. 2023;15(5):1558. doi: 10.3390/cancers15051558 - DOI - PMC - PubMed
    1. Moreau P, Kumar SK, San Miguel J, et al. Treatment of relapsed and refractory multiple myeloma: recommendations from the International Myeloma Working Group. Lancet Oncol. 2021;22(3):e105–e118. doi: 10.1016/s1470-2045(20)30756-7 - DOI - PubMed
    1. Dimopoulos MA, Moreau P, Terpos E, et al. Multiple myeloma: EHA-ESMO clinical practice guidelines for diagnosis, treatment and follow-up. HemaSphere. 2021;5(2):e528. doi: 10.1097/hs9.0000000000000528 - DOI - PMC - PubMed
    1. Bhatt P, Kloock C, Comenzo R.. Relapsed/Refractory multiple myeloma: a review of available therapies and clinical scenarios encountered in myeloma relapse. Curr Oncol (Toronto Ont). 2023;30(2):2322–2347. doi: 10.3390/curroncol30020179 - DOI - PMC - PubMed
    1. Terpos E, Mikhael J, Hajek R, et al. Management of patients with multiple myeloma beyond the clinical-trial setting: understanding the balance between efficacy, safety and tolerability, and quality of life. Blood Cancer J. 2021;11(2):40. doi: 10.1038/s41408-021-00432-4 - DOI - PMC - PubMed

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