Global Disparities

In this Health Tree University lesson, you will learn about the existing global disparities in multiple myeloma. So if you look at the global landscape, you know, in the US, we're sort of blessed to have many healthcare systems, but many other countries, there is not as big of a robust system available to them. If you look at Europe, you know, obviously the French group is very good, and so is the Spanish group, but that's not kind of available on a global landscape, which makes things a little harder. So there's fewer hospitals and even fewer cancer centers that are available to patients. There's even a fewer number of professionals both in healthcare that includes nurses, nurse practitioners or physicians that are focused on multiple myeloma. Very few countries have myeloma centers of excellence. I do think this leads to issues in terms of seeing a specialist or seeing someone who can help the patient in a timely manner and leads to delays in care and obviously disparities in care. Also, there's the issue of health insurance coverage. You know, in many countries, financial restrictions are there in terms of how wealth and resources get spread out across the nation. That can lead to delays in therapy that can be given to the patient, but also delays in getting therapies on national formularies, for example. So and I think that can lead to sort of a disparity depending on where you are. And that also leads to a problem where there's delayed access to novel therapies such as CAR-Ts and Biopsy. Right now, in the US, we have two CAR-Ts that are available for multiple myeloma, but there's multiple parts of the world where they don't even have the infrastructure to do CAR-Ts, let alone access to CAR-Ts. And that is sort of like very much reflected when you look at the outcomes for patients who are treated on clinical trials versus patients who are treated in other countries and other parts of the world. So even if we kind of look beyond the newest and shiniest therapies that we have, such as CAR-Ts or Bi-6 T cell engagers, even therapies that such as Dereptimumab, Isotoximab, Pumalidomide, Carfosumab, things that therapies that we use very commonly in the United States at academic centers, they may not be available in other parts of the world. And I'm not even talking like places that are in the developing world, but also like I'm talking about places like Europe, where it takes a longer time for drugs to make it through the EMA and also then through the national formulary. So while these countries do get access to some of the clinical trials, if they get selected to be part of it, the patients there do struggle to get access to these novel therapies. For example, like many parts of Europe don't have access to Pumalidomide. So they're still using Phthalidomide fairly frequently in their regimens. And lastly, I also would like to point out that while we do want to get patients access to novel and innovative clinical trials, there is an issue of access as well. Like many countries, for example, do not have the structure and infrastructure to be part of clinical trials. So they just don't get the benefit from that. And as we know, it can take many years for a specific therapy to go from clinical trials to being commercially available. And that's time during which these patients don't get access to these specific therapies, which is very, very sad for them.