OBJECTIVES

Despite recent advances in Multiple Myeloma (MM) treatment there is little data describing pathway and resource impact. The objectives of this study were to understand the demographics, clinical characteristics, and secondary care burden for MM patients up to and including second-line (2L) therapy.

METHODS

A retrospective cohort study was conducted using English Hospital Episode Statistics data. Patients with an MM diagnosis code (C90.0) between April 2014-May 2020 were identified. A novel algorithm was developed to construct line of therapy (LOT) cohorts. Patients with a first MM-related admission after April 2015 (chosen to avoid identifying previously treated patients) were assumed to be untreated/newly diagnosed (NDMM). Patients with ≥3 chemotherapy start codes (a line of therapy), or ≥1 stem-cell transplant (SCT) were considered first-line (1LMM). Patients with ≥3 chemotherapy start codes, a subsequent gap of >35 days and another chemotherapy start code were characterised 2LMM. Patients with 1 SCT followed by a chemotherapy start code and patients with 2 SCTs were automatically included as 2LMM.

RESULTS

The NDMM cohort included 41,208 patients. Of these, 19,828 (48.1%) were deemed to fit the criteria for 1LMM and 7,449 (18.1%) to fit the criteria for 2LMM. The average age of NDMM, 1LMM and 2LMM patients was 72.4 (60.2-84.7), 69.3 (57.9-80.3) and 66.4 (55.6-77.2) years respectively. NDMM patients had 3.32 inpatient admissions and 5.91 outpatient events. During 1LMM, this increased to 19.97 inpatient and 14.21 outpatient events. The most common condition treated at 1LMM was sepsis. In 2LMM, infection was the most prevalent (73%). Renal failure was recorded in 45% of NDMM, 47% of 1LMM and 49% of 2LMM patients.

CONCLUSIONS

These data provide important insights into the characteristics of MM patients up to and including 2L and the burden imposed on the NHS due to MM. The resource utilisation identified may provide useful metrics for health economic modelling.