OBJECTIVES: Multiple Myeloma (MM) accounts for a small percentage of all cancer types, nonetheless with a relevant burden of disease. Economic data at a country level remains scarce. This study aims to assess the burden that indirect costs represent on MM, in Portugal. The results will hopefully promote disease awareness and raise importance of indirect costs impact in society.

METHODS: MM indirect costs in Portugal were evaluated from the third-party payer perspective. Impact was measured considering absenteeism (patient and caregiver), presenteeism and early retirement. The cost of premature death was also assessed considering a more comprehensive societal point of view. Key data sources were computed in an excel model that gathered epidemiological data from reference published papers, complemented with two expert panels of hematologists and hematology nurses and a close collaboration with a patient association. Costs were valued according to official public data sources considering the most recent data available.

RESULTS: The total indirect costs of MM in Portugal in 2021 are estimated at € 15.929.457 being € 7.042 per patient. The cost increases to € 67.118.090 if premature death is also considered. Based on a study from 2019 (Neves M. et al.), that estimated a total of € 71.137.638 direct costs associated with MM in Portugal, one gets an overall annual cost of € 87.067.095, an average of € 38.491 per patient, with a proportion of 82% direct costs vs. 18% indirect costs.

CONCLUSIONS: Indirect costs seem aligned with other MM costs of illness studies (Petrucci, M. T. et al.), showing a very similar pattern between direct and indirect costs. Although direct costs are considerably higher, this study shows that indirect costs are also relevant and a burden for the third-party payer (social security). In further assessments, MM impact should be measured considering not only direct but also indirect costs.