Introduction: Multiple Myeloma

BACKGROUND: Multiple myeloma (MM) is the most common type of primarybone tumor, affecting approximately 50,000 patients in the United States.Although it is currently not curable, recent advancements in treatmentare bringing myeloma closer to becoming a chronic disease instead of aterminal illness. OBJECTIVES: To better understand the prevalence of MM as well as providean overview of the costs associated with treatment. SUMMARY: The goals of treatment in MM include eradicating all evidence of disease, controlling disease to prevent damage to target organs, preserving normal function and quality of life, relieving pain, and managing myelomathat is in remission. To achieve these goals, treatment must be individually tailored for each patient based on the patient’s age, overall health status,symptoms, and laboratory test results. Advancements in the understanding of the pathogenesis of myeloma andthe role of genetic mutations are leading to a new standard of treatment. Advancements in diagnostic technology, such as cytogenetic testing, are also being used to tailor treatment for each individual to work toward achieving better response rates, longer periods of remission, and improved quality of life. Increased costs associated with the improved therapies being used to treat MM, and the comorbid conditions associated with the disease, present a challenge to managed care. Health plans and formulary decision makers need to better understand the complexity of therapy to best use resources.The economic burden to the patient must also be considered when developing treatment strategies. CONCLUSIONS: Better understanding of the pathophysiology of MM,including the role of cytogenetics, is leading to the development and useof novel agents and treatment options. Head-to-head studies comparing treatments must be performed to best balance the costs associated with treatment and the benefits of improved survival rates and maintaining quality of life.