IMS 2025 | The challenges in managing myeloma in LMICs compared with high-income countries

There are many disparities. In particular in my country, in Brazil, we have a universal public health system. So for the whole population, 210 million people, there is a universal health system. But we have at least 25% of this population that has a health insurance plan. So, the two systems are truly unbalanced. The most innovative drugs, including CAR-T, including bispecifics, daratumumab, elotuzumab, they are all approved in Brazil. But only for the public in the private health system, they are reimbursed. So it’s really unbalanced, the therapeutic strategies when I compare it to public and private. And this is really unfair. So for the public, we have reimbursement only for thalidomide, bortezomib, and carfilzomib. Lenalidomide is not yet approved, reimbursed. It’s approved, but it’s not yet reimbursed for the public. So this situation, this particular situation in my country, in Latin America, all around the world, maybe different problems, but the same unfair system. So you need to really improve the access of the patients, of the whole population, to the innovative drugs. You know very well that the cost of the treatment increases year by year. But there are huge differences in survival when you compare strategies. For example, for first-line treatment with the quadruplet combination, you can do it in the private sector, the combination of dara-VRd, but you cannot do it in the public. You can do lenalidomide and daratumumab maintenance in the private, but you cannot do it in the public. So this creates an unfair system. So I’m also the president of the Brazilian Society of Hematology. Inside our society, we created in 2018 a drug access committee to really try to improve and to negotiate with the government, with the Minister of Health as a scientific society to increase drug access, in particular in the public health system. I stimulate other countries, poor and middle-income countries, that those countries can involve their scientific society in this process. You are really responsible for the treatment of our patients, and drug access is a critical point nowadays.

This transcript is AI-generated. While we strive for accuracy, please verify this copy with the video.