Anti-CD38 treatment patterns in multiple myeloma patients with Medicare/Medicaid versus private insurance.

Abstract

e19575 Background: Multiple myeloma (MM) is one of the most common hematological malignancies, and the incidence of MM continues to increase around the world. MM survival has increased dramatically over the past 10 years, partially due to the introduction of anti-CD38 antibodies in different stages of MM therapy. MM patients with Medicaid/Medicaid are at higher risk of morbidity and mortality likely related to their access to different treatment modalities. We explored anti-CD38 treatment patterns in patients with private insurance versus Medicare/Medicaid. Methods: Data were extracted from Altopros Evidence Network from 1/1/2020-10/3/2025. The Altopros Evidence Network was searched for patients 18 years or older with MM. We then separated the MM cohort into patients with private insurance versus Medicare/Medicaid, and examined use of anti-CD38 antibodies at 30 days from diagnosis and within 6 year. We identified 5176 patients in the Medicare/Medicaid group and 11715 patients in the private insurance group. Results were powered to p<0.001. Results: The Medicare/Medicaid cohort was older than the private insurance group (the median age was 73.6 years and 65.8 years, respectfully) and had a higher percentage of peripheral vascular disease (38.3% vs 23.7%) and cerebrovascular disease (29.1% vs 18.1%). After propensity score matching, the use of CD38 directed therapy within 30 days was not statistically significantly higher in the private insurance group than the Medicare/Medicaid group (IRR 0.987, 95% CI 0.818-1.19, p=0.89). The use of CD38 directed therapy within 6 years was also not significantly higher in the private insurance group (IRR 0.934, 95% CI 0.843-1.03, p=0.187). Conclusions: Patients with private insurance did not have a statistically higher chance of being placed on anti-CD38 directed therapy within both 30 days and 6 years after diagnosis than those with Medicare/Medicaid. This suggests that access to anti-CD38 antibodies may not be related to increased morbidity/mortality experienced in patients with Medicare/Medicaid with MM.