Assessment of Real-World Treatment Patterns and Healthcare Resource Utilization (HCRU) in Patients with Lenalidomide-Refractory Relapsed/Refractory Multiple Myeloma (RRMM) from the US Optum Database

OBJECTIVES: Characterize real-world treatment patterns and HCRU in RRMM patients receiving 1–3 prior lines (PL) of therapy.

METHODS: Patients with MM (index in/after Jan 2016) from the Optum US Claims database were included if they received 1-3 PL (including a PI and lenalidomide, or refractory to lenalidomide if only 1 PL), had no prior anti-BCMA exposure, and were not anti-CD38 mAb-refractory. Index date is the start of first subsequent line of therapy (LOT) post-inclusion. The analysis considered only the first index per patient. Baseline characteristics and LOT patterns were assessed with descriptive statistics. Time to next treatment (TTNT) was estimated for patients with commercial insurance and patients with Medicare using the Kaplan-Meier method starting at index. Per-patient per-month (PPPM) number of outpatient visits, hospitalizations, emergency room (ER) visits, and lab visits from first LOT to loss to follow-up were assessed.

RESULTS: Of 16,402 patients with an index diagnosis of MM and ≥1 LOT, 1,646 met inclusion criteria. The median age was 73 years; 4.0% received stem cell transplant before first index; the median Charlson Comorbidity Index was 2. Hypertension was the most common comorbidity (63.3%). The median time from index to end of follow-up was 11 months. 28.9% of patients had commercial insurance. Treatment patterns varied widely. The median TTNT was 6.1 months overall, 4.9 months for patients with commercial insurance, and 6.9 months for those with Medicare. Mean (SD) PPPM outpatient visits, hospitalizations, ER visits, and lab visits were 4.5 (2.8), 0.1 (0.4), 0.2 (0.3), and 1.9 (1.2), respectively. Mean (SD) PPPM length of stay was 0.9 (2.0) days. HCRU was similar between patients with private insurance and Medicare.

CONCLUSIONS: PI- and lenalidomide-exposed RRMM patients with 1-3 PL progressed quickly through various regimens, incurring high HCRU, and highlighting an unmet need for newer effective regimens for this population.