Health-related quality of life and financial toxicity in Chinese patients with multiple myeloma: a two-year real-world multicentre study.

Abstract

Background: The introduction of novel therapeutic agents has transformed the treatment landscape and significantly improved survival outcomes for patients with multiple myeloma (MM). However, the effects of these advancements on health-related quality of life (HRQoL) and financial toxicity in real-world settings remain insufficiently explored. The aim of this study was to investigate HRQoL and financial toxicity among Chinese patients with MM in the era of novel agents.

Methods: In this longitudinal, multicentre, real-world study, data from Chinese patients with MM were collected between March 2021 and July 2023. HRQoL was assessed using the EQ-5D-5 L, EQ-VAS and FACT-MM, while financial toxicity was measured using the Comprehensive Score for Financial Toxicity (COST). Patients were evaluated at baseline and at 3-, 6-, 12-, and 24-month follow-up visits. Mixed-effect models were employed to examine the factors associated with HRQoL and financial toxicity over time.

Results: A total of 441 patients were surveyed at baseline, with 412 (93.5%), 371 (84.1%), 335 (76.0%), and 253 (57.4%) completing the follow-up visits at 3, 6, 12, and 24 months, respectively. At baseline, the mean EQ-5D-5 L, EQ-VAS, FACT-MM, and COST scores were 0.79 (SD = 0.25), 81.96 (SD = 18.73), 117.46 (SD = 21.76), and 21.84 (SD = 5.78), respectively. The EQ-5D-5 L utility values and FACT-MM scores at follow-up visits were significantly higher than those at baseline, whereas the COST scores were significantly lower. Mixed-effect model analyses revealed that higher levels of financial toxicity were significantly associated with lower HRQoL (EQ-5D-5 L: β = 0.006, p < 0.001; FACT-MM: β = 1.60, p < 0.001). Moreover, significant interaction effects between socioeconomic status and COST were observed for both the EQ-5D-5 L (β = -0.001, p < 0.001) and the FACT-MM (β = -0.12, p < 0.001).

Conclusions: HRQoL improved moderately over the 24-month follow-up period, whereas financial toxicity progressively worsened. Greater financial toxicity was significantly associated with poorer HRQoL, particularly among patients with lower SES. These findings may inform future health policy development and economic evaluations aimed at improving the quality of care and financial well-being of patients with MM.