Patient-reported economic impact of relapsed or refractory multiple myeloma “document the substantial direct medical costs” as well as identify the “indirect, social costs associated with this disease,” a study reported at the 57th American Society of Hematology (ASH) Annual Meeting.1

“Healthcare budget holders seek meaningful cost offsets from new therapies,”  said Robert Z. Orlowski, MD, PhD, of The University of Texas MD Anderson Cancer Center in Houston, TX, while explaining the rationale for the study.

Dr. Orlowski and colleagues analyzed data from a patient economic questionnaire that inquired about recent disease-specific medical utilization, workforce status, and caregiver burden. The patients had relapsed or refractory multiple myeloma and were enrolled in a global phase 2 randomized study. Patient-reported health questionnaires included the Brief Pain Inventory (BPI) pain intensity and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) scales.

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Of the 307 patients who enrolled in the study, 267 completed the questionnaire. Median age was 63 years; 53.9% were male and 91.8% were Caucasian. A total of 20.9% reported moderate pain and 10.3%, severe pain; in addition, 36.8% reported moderate fatigue and 34.2%, severe fatigue.

Among the respondents, 107 (42%) reported at least 1 hospital visit over the previous 6 months and, over the previous 3 months, 185 (71.1%) reported a specialist visit and 86 (33.1%) a family physician visit.

Of the respondents, 28 (11.6%) were working and 236 (89.4%) were not. Among those working, 39% reported absenteeism due to their disease of at least 1 day over the previous 4 weeks. A total of 48.7% of those not working attributed this to their disease. Of the 80% of patients who had retired, 32.4% reported taking early retirement due to their disease.

About two-thirds (63.1%) of the patients had not received disease-driven disability compensation, and about one-fifth (19.9%) reported their caregivers had missed working days.

“Results support those from previous studies on the impact of multiple myeloma on productivity and employment status,” Dr. Orlowski said. “Generally, higher morbidity and worse EORTC Global Health scores are associated with greater direct and indirect economic impact.

Next steps include longitudinal multivariate analyses, hypothesis testing in future clinical trials of multiple myeloma, and further psychometric refinement of the questionnaire.


1. Robinson D, Orlowski RZ, He J, et al. Economic burden of relapsed or refractory multiple myeloma: results from an international trial. Oral presentation at: 57th American Society of Hematology (ASH) Annual Meeting & Exposition; December 7, 2015; Orlando, FL.