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Multiple Myeloma: eHCPs in the US and Canada advocate for a patient-centric approach

19.12.2023 | Insight

Multiple Myeloma: eHCPs in the US and Canada advocate for a patient-centric approach

CREATION.co retrospectively analysed nearly 13K posts by 1,186 eHCPs in the US and Canada from 01 November 2022 to 31 October 2023. Key takeaways included: 

  • eHCPs advocate for equitable healthcare access in ethnic minorities.
  • Patient preferences, safety and affordability were key for eHCPs deciding treatment.
  • eHCPs engaged with Patient Advocacy Groups (PAGs) to advocate for better patient care.
  • eHCPs considered patient factors such as refractory status and transplant eligibility when sequencing treatment.

Online healthcare professionals (eHCPs) in the US and Canada adopted a heavily patient-centric approach when discussing treatments and trials in the multiple myeloma space. They advocated for patient well-being, safety and equitable healthcare access. They tailored treatment to accommodate patient preferences, affordability and prognostic factors. 

eHCPs highlighted healthcare disparities for black and Hispanic patients

16% of discussions among eHCPs related to multiple myeloma focused on racial disparities. eHCPs delved into the underlying reasons and proposed solutions to ensure equitable healthcare access. 

eHCPs discussed unequal healthcare access and poor trial representation of black patients 

Nearly half of these discussions centred around challenges faced by the black community.  eHCPs brought attention to the fact that African Americans had half the survival rate and worse treatment outcomes than white Americans, which was symptomatic of systemic problems and healthcare inequality as opposed to biological differences.

eHCPs emphasised the underrepresentation of black people in trials, citing examples such as the KarMMA-3 trial with only 9% representation and the ide-cel trial with 7%. eHCP Samer Al Hadidi, a haematologist-oncologist in Arkansas, expressed that the ‘field continues to fail minority patients’ in this regard, and attributed the underrepresentation of black participants to the lack of trial locations in areas with higher proportions of the black community. 

eHCP Tanya Wildes noted that ‘the word “trial” was potentially stigmatizing for black people with myeloma’. To increase awareness of multiple myeloma within the black community, Rahul Banerjee, a haematologist-oncologist in Washington, shared webinars. Additionally, haematologist Joseph Mikhael improved public awareness by posting polls that shed light on the trial and healthcare disparity experiences of African Americans. Moreover, eHCPs like oncologist Saad Usmani reposted details of a funded scholars program for black researchers to improve black representation in multiple myeloma research. 

eHCPs attributed worse outcomes in Hispanic patients to systemic and financial barriers

Of the 216 posts related to racial disparity, 13% focused on Hispanic patients, with some eHCPs reposting research conducted by Dr Hadidi on the healthcare challenges faced by Hispanic patients.

Dr Hadidi claimed that 59% of studies reported worse outcomes in Hispanic patients, and noted that they had a higher inpatient mortality rate than other ethnic minorities. 

In his research, Dr Hadidi attributed their worse outcomes to a generally lower socioeconomic status and lack of health insurance among Hispanic communities, discriminatory laws, financial barriers and late adoption of novel therapies among Hispanic patients when compared to non-Hispanic Whites. He advocated for national-level structural reforms to combat these issues. 

Further emphasised in his research was the meagre 1.3% participation of Hispanics in trials. Hence, he stressed the pivotal role of patient education in improving this number. Highlighting an interesting trend, Dr Hadidi pointed out that minority patients tend to prefer physicians from their own ethnic backgrounds and that Hispanic physicians represent just 5.8% of the medical workforce. To address this disparity, he proposed diversification of the workforce to increase this number and encourage more minority patients to seek treatment.

eHCPs also shared research conducted by David Gómez-Almaguer on the challenges and health disparities faced by Hispanic patients in the Latin America (LATAM) region, indicating that their advocacy for equitable healthcare access in the Hispanic community extended beyond North America.

eHCPs noted high trial ineligibility rates among ethnic minorities

40% of racial disparity posts focused on ethnic minorities in general. Mainly discussed were their high trial ineligibility rates, with DOL Joseph Mikhael highlighting a 24% rate for black people and 20% for Latinos.

eHCPs also shared research on racial disparities in multiple myeloma presented at the ASCO 2023 congress.

eHCPs advocate for better patient support in multiple myeloma

The perceived mistrust of HCPs among older black patients was raised as a possible barrier to healthcare access and clinical trial participation. 

To address this, eHCPs reshared content by patient advocacy groups International Myeloma Foundation and HealthTree Foundation for Multiple Myeloma on strategies to dissolve patient mistrust and advocate for patients. eHCPs also reposted European PAGS like Myeloma UK that praised compassionate care from an NHS team of haematologists. 

eHCPs’ treatment decisions are guided by patient factors and wellbeing 

Teresa Miceli, among other eHCPs, advocated for patient-centred care prioritising patient preferences and quality of life, especially for the frail. 

eHCP Sridevi Rajeeve, among others, highlighted the use of a tailored approach to treatment sequencing based on the prognostic factors specific to each patient, rather than adopting a pre-specified treatment regimen for all patients.

Two eHCPs considered patient comfort, preferring hospitalisation for specialised care but outpatient care for lower costs and greater patient happiness. 

When deciding treatment, eHCPs predominantly considered FDA approval, trial results demonstrating drug efficacy and safety in patients, and if the drug was a valuable alternative for patients.

For instance, eHCPs celebrated the accelerated FDA approval of elranatamab, its efficacy for heavily pretreated patients and bi-weekly dosing schedule which meant reduced costs.

However, of the negative elranatamab posts, 75% raised concerns about the high risk of infections, 44% fatality and 50% dropout rate due to severe adverse events – in a trial combining elranatamab with daratumumab.

eHCPs discussed the risk of infection in trials and drug administration modes in the interest of patient safety, with some preferring intravenous delivery of bispecific antibodies for lower infection risk, and others choosing subcutaneous delivery for better clinical efficacy.

Research shows patient-centric approach

eHCPs in Canada and the US advocate for a patient-centred approach to multiple myeloma treatment and equitable healthcare for their patients. 

In our analysis we saw them sharing research on the causes of underrepresentation and treatment access in black and Hispanic communities as well as suggesting remedial measures:

  • Engaging with local and European PAGs to spread awareness about multiple myeloma in these minorities and to dissolve patient mistrust of HCPs. 
  • Encouraging peers to remember that they were treating people and not a condition, hence the need to prioritise patient well-being, individual prognostic factors and quality of life in all treatment decisions. 
  • Bringing clarity on the pros and cons of treatment location and regimens, and the importance of considering patient affordability, safety, side-effects and comfort. 

Genuine concern for patients and a need for equitable access to healthcare among races shaped eHCP conversations in the multiple myeloma space, with influential eHCPs known as Digital Opinion Leaders acting as significant drivers of these conversations among peers. 

To discuss these findings in more detail or understand the needs and views of HCPs in your markets and therapy area, let us know, we’d love to chat.

 

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Meet the Author

Eden Daniel

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