Quality of Life Disparities Persist in R/R Multiple Myeloma Despite Universal Health Care: Francesco Sparano, MSc

In part 2 of an interview conducted at the European Hematology Association 2025 Congress, Francesco Sparano, MSc, research associate in the health outcomes research unit at the Italian-based GIMEMA Foundation, expands on findings from his abstract, “Association Between Socio-economic Inequalities and Health-Related Quality of Life of Patients With Relapsed/Refractory Multiple Myeloma: Analysis From the GIMEMA-CLARITY Study," which he summarized in part 1.

He also discusses potential interventions to help address disparities in health-related quality of life among patients with relapsed/refractory multiple myeloma from lower socioeconomic backgrounds.

This transcript was lightly edited; captions were auto-generated.

Transcript

To elaborate on your findings, were you surprised by any of the differences in health-related quality of life outcomes across socioeconomic groups? Why or why not?

There are many results that are interesting to analyze. For example, clinically important levels of pain [were] reported by 80% of patients in the low socioeconomic status group. [Meanwhile,] the same symptom was reported by less than 50% of patients In the high socioeconomic status group.

Another important finding was the level of financial difficulties that was also examined in this study. For example, we found that only one quarter of patients in the high economic status group reported a level of financial difficulties that limited their daily life. But this prevalence was twofold among patients [in the] low socioeconomic status group. This is not so surprising, but in a country like Italy or the UK, where there is universal care coverage, it's important to highlight this finding.

As you just mentioned, disparities in health-related quality of life persist even in countries with universal health care. What factors beyond access to care do you believe contribute to this gap?

In this study, we did not explore the specific mechanisms behind these inequalities, but we can hypothesize based on previous studies that these socioeconomic inequalities persist also in countries like Italy or the UK because, in general, patients with a lower socioeconomic position have also lower resources, like money, like knowledge, that might be very important at the time of disease or treatment.

Just to [give] an example, patients with lower economic resources may have lower economic availability that can be helpful, for example, to pay [for] the treatment for managing pain. This may explain, for example, the difference that we observed in symptoms like pain.

What types of interventions do you think could help address the health-related quality of life disparities among patients with lower socioeconomic status?

This is a difficult question because it [does not] require a simple answer because there are many interventions that should be taken to contrast these inequalities. This intervention should be multi-level and should involve many actors.

For example, from the point of view of a researcher, we should try to standardize the way we measure the socioeconomic inequalities, the social determinants of health, because there are many factors that may contribute to these inequalities. Usually they are assessed differently from study to study.

We also need, for example, to measure these differences, not only in clinical trials, but also in clinical practice, in order to better identify which are the most vulnerable populations that could benefit from targeted interventions. Lastly, it is important to start to design and evaluate the effectiveness of the specific interventions aimed at minimizing these difficulties and these disparities.