OBJECTIVES: RRMM remains incurable making long-term clinical management complex. Furthermore, disparities in mortality, incidence and treatment utilization exist, with newer, more effective and expensive therapies underutilized. Better understanding of disparities in healthcare resource utilization (HCRU) and treatment patterns is necessary to improve outcomes for these patients.

METHODS: This retrospective, observational analysis examined administrative claims from Medicare Fee-For-Service (FFS) patients with RRMM who initiated 2L/3L therapy from 01/01/2016 to 12/31/2020. Patients were stratified by line of therapy (2L or 3L), ethnicity (White, Black, or other ethnicities), and location (urban or rural residence). The distribution of treatment regimens and rates of specific HCRU by line of therapy were reported descriptively.

RESULTS: Of the 2L group (n=4560), 80.1% were White and 13.6% Black; 71.9% resided in an urban setting. Of the 3L group (n=11,991), 81% were White and 13.4% Black; 71.0% resided in an urban setting. Treatment regimens used did not differ greatly, with the most frequently-used agents remaining similar between subgroups. More Black patients presented for emergency care (measured by emergency department visits) than White patients in 2L (36.3% and 30.2%) and 3L (35.2% and 27.7%). Black patients had more frequent inpatient care (≥1 hospitalizations) than White patients in 2L (43.4% and 35.7%) and 3L (37.5% and 34.9%). Similarly, more patients presented for emergency care and inpatient care (≥1 hospitalizations) in the rural versus urban setting in 2L (36.6% and 28.6%, 38.3% and 35.8%) and 3L (33.6% and 26.7%, 38.6% and 33.9%).

CONCLUSIONS: Although this study identified no differences in treatment patterns, immediate and inpatient care services were used more frequently and by a higher proportion of Black patients. Discrepancies in immediate and inpatient care between residential settings were also observed. This study highlights a need for research to better understand causes of these discrepancies to inform on and improve care-related decisions.