OBJECTIVES: Assess the level of funding and positioning that brand-brad Multiple Myeloma combination therapies have achieved in Argentina, Brazil and Mexico, and identify potential regional hurdles to effective access.

METHODS: Level of funding from available combination was sourced from publicly available drug formularies in Argentina (‘Sistema Unico de Reintegro’, PAMI ‘vademecum’ and IOMA ‘vademecum’), Brazil (CONITEC and ANS ‘Rol’) and Mexico (CSG, IMSS and ISSSTE ‘Cuadro Basico’).

RESULTS: Access to brand-brand Multiple Myeloma combination therapies remains largely protracted across Argentina, Brazil and Mexico. Apart from private providers in Brazil that are mandated to fund all IV oncologics, most public institutions in Argentina, Brazil and Mexico do not provide broad funding for brand-brand combinations. Instead, these are assessed on a named-patient basis and typically reserved for very late lines of treatment 2L+. For example, the carfilzomib-lenalidomide-dexamethasone triplet was incorporated in CSG ‘Cuadro Basico’ in 3L+, after an initial negative assessment in earlier lines.

Restrictive access is likely driven by budgetary concerns stemming from the additive cost of combinations, uncertainty around the duration of therapy in treat-to-duration regimens, growing population size in early lines of therapy, and concerns around the transferability of clinical trial results to the local setting.

CONCLUSION: Access to brand-brand Multiple Myeloma combination therapies remains protracted in Argentina, Brazil and Mexico mostly driven by budgetary concerns. Innovative approaches are needed to identify sustainable solutions to incorporate these therapies into public sector formularies.