Index Finds Half of MM, CLL Patients in Study Had Financial Difficulty

Financial difficulty during treatment for multiple myeloma (MM) or chronic lymphocytic leukemia (CLL) was associated with lower levels of education, incomes below $60,000, and multiple comorbidities.

Addressing the financial challenges of patients receiving treatment for blood cancers is a growing concern as the number and complexity of drug regimens increases, according to authors of a study presented last month during the 2022 annual meeting of the American Society of Clinical Oncology.

The authors recruited 521 adult patients with either multiple myeloma (MM) or chronic lymphocytic leukemia (CLL) to answer questions from a well-known survey, the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30).

According to the authors, financial difficulty was measured by a previously validated single question from the questionnaire, and a composite measure of 5 questions from the questionnaire.

Of the 521 patients, 416 patients took all or part of the survey for an overall response rate of 79.8%. On the single question, 16.8% of the respondents reported experiencing financial difficulty; on the composite index of 5 questions, 58.6% reported experiencing financial difficulty.

The patients who reported financial difficulty to both measures said their household incomes were below $60,000 and their highest education levels were a high school diploma or GED. According to authors, the patients “had more than 1 medical comorbidity and used an expensive oral chemotherapeutic agent.” The mean number of comorbidities was 5.1.

Overall, 45.8% of the respondents earned less than $60,000; 75.7% of the respondents to the single question earned less than $60,000, while 58.2% of those who reported difficulty based on the 5-question index earned less than $60,000.

Data from the survey showed that 89 (28.9%) of the respondents had private insurance, while 100 (32.5%) respondents had public insurance. Of those with public insurance, 37.1% answered positively to the single validated question on financial difficulty and 37.3% reported difficulty based on the 5-question index. Of those with private insurance, 37.1% reported answered positively to the single question and 26.2% reported financial difficulty based on the 5-question index.

Among the respondents, 42.9% had a high school diploma or GED, but among those reporting financial difficulty based on the single question, 62.9% had a high school diploma or GED; while 50.4% of the respondents identified through the 5-part index had a high school diploma or GED.

By contrast, 16.2% of the overall respondents had a bachelor’s degree, but only 11.4% of those answering the single question and 14.3% of those answering the composite question, who had more than a bachelor's degree, identified as having financial difficulty.

The therapeutic agents included in the definition of “expensive oral therapeutic agents” were: ixazomib citrate, lenalidomide, panobinostat, pomalidomide, thalidomide, chlorambucil, ibrutinib, idelalsib, and venetoclax.

Patients with blood cancer treated at the NCI-affiliated sites experienced difficulties, the authors said. “Results of this study aim to inform physician, site of care and policy efforts to improve access among cancer patients,” the authors wrote.


Conti RM, McCue S, Dockter T, et al. Self-reported financial difficulties among patients with multiple myeloma and chronic lymphocytic leukemia: an Alliance for Clinical Trials in Oncology study. J Clin Oncol. 2022;40(suppl_16):Abstr 6602. doi: 10.1200/JCO.2022.40.16_suppl.6602

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