Multiple myeloma, a catastrophic disease that demands investment in innovative treatments that increase survival.

Multiple myeloma , a type of blood cancer that affects the plasma cells in the bone marrow, represents a catastrophic disease that demands the collaboration of public and private health systems, as well as governments, insurance companies, and the pharmaceutical industry to facilitate access to innovative therapies that help increase survival rates, according to medical specialists and representatives of civil organizations.

“The costs of multiple myeloma can be catastrophic. But beyond just considering how much the drugs cost, we must value the benefit we are bringing to the patient, enabling them to resume their lives, return to work, reintegrate into society, and remain productive,” said Alín Ramírez Alvarado, an attending physician and head of the Multiple Myeloma Clinic at the Centro México Nacional La Raza.

In Mexico, an average of 31 cases of multiple myeloma are treated every day, according to data from the Mexican Social Security Institute (IMSS). In 2022 alone, 2,346 new cases and 1,507 deaths were recorded.

This disease primarily affects men , according to Globocan, an international platform for cancer data and statistics.

Alín Ramírez added that the institution he represents is focused on improving the outcomes of patients and giving them hope for a longer life and how they can reintegrate into society, rather than on the overall cost of treatment.

"And I believe that from that starting point, we are radically changing access to therapies," added the hematologist after her participation in the "Educational Workshop on Multiple Myeloma," organized by the pharmaceutical company Pfizer.

María Victoria Mateos, head of the Myeloma Unit at the University Hospital of Salamanca in Spain, commented that access to innovative therapies depends largely on agreements between pharmaceutical companies and governments, which vary from country to country.

One challenge for countries like Mexico is to ensure universal access to innovation, independent of patients' economic status or geographic location, he commented at the same event.

He emphasized that the United States leads the way in drug approvals thanks to its more flexible regulations. While in Latin America, particularly Mexico, treatments often arrive late.

Therefore, he considered the importance of integrating hematologists, working groups, and pharmaceutical companies to bring clinical trials to the country, as this will help patients access innovative therapies more quickly.

In her turn, Paulina Rosales, director of Unidos Pro Bone Marrow Transplant Francisco Casares Cortina , emphasized that the reality of people with health insurance is very different from that of those receiving treatment in institutions without social security.

He explained that for the federal government, it's better to invest in drugs that allow patients to return to productive life more quickly, rather than keep them on various treatments without recovery.

Barriers to access to innovative treatments

The specialists agreed that, although there have been advances in treatments, patients with multiple myeloma still face some barriers , such as late diagnosis, as it can take more than 12 months to be diagnosed and receive treatment.

Furthermore, they may be treated by between four and seven specialists before being referred to a hematologist. This means they often present with severe symptoms, including kidney damage or fractures that can leave them immobile.

Other barriers include a lack of medical and public education about the disease, as well as unequal access to innovative treatments, high out-of-pocket costs, and a significant impact on families and society.

In this regard, Alín Ramírez emphasized that the treatment paradigm for patients with multiple myeloma has changed radically in recent years.

"From dancing with the ugliest, we start dancing with the treatment that gives us the best prognosis," he added.

He explained that treatments such as immunotherapy and CAR-T cells have increased patients' survival rates, so it's critical to ensure access to these treatments and move forward with these innovations.

Although he acknowledged that Mexico has made progress in approving effective, scientifically backed drugs by regulatory agencies, the challenge of timely and equitable access remains.

"As physicians, we need to demonstrate that patients need to present their data to public institutions, but also to private ones because insurance companies sometimes take a long time to approve drugs. The second step is to ensure access for all," said the specialist from the Mexico National La Raza Center.

"It may sound like a slogan," he added, "but no patient in Mexico should be left out of innovative therapies." Therefore, he believed that all efforts should be directed toward curing this disease.

Dr. Mateos offered a message of hope to patients, emphasizing that multiple myeloma is a disease whose evolution is changing.

"Our commitment as hematologists is to offer them the longest possible survival," he emphasized, and with innovative treatments, this is possible.

Finally, Paulina Rosales considered that we are at a critical moment because Mexico is seeking to evolve in the health sector and is placing a significant focus on primary care.

Therefore, if this issue is put on the agenda, it is possible to make innovative medicines accessible to patients.

Multiple myeloma is a blood cancer that affects plasma cells, which are responsible for producing antibodies. Although the exact cause is unknown, risk factors include having family members with the disease, being over 60 years of age, being obese, and being male.

In its early stages, there may be no symptoms, but over time, it causes anemia, infections, kidney damage, high levels of calcium in the blood, bone pain (mainly in the spine, chest, and hips), as well as nausea, constipation, loss of appetite and weight, confusion, fatigue, weakness, excessive thirst, and frequent urination.