Access to timely and effective treatment for hematologic malignancies, such as multiple myeloma (MM), remains a critical challenge for many patients. Barriers to care—including socioeconomic disparities, geographic limitations, and systemic inefficiencies—can adversely impact outcomes, particularly for under-resourced populations. Addressing these barriers requires a multifaceted approach tailored to the complexities of these diseases.
Socioeconomic Barriers: High treatment costs, inadequate insurance coverage, and out-of-pocket expenses often limit access to essential therapies, such as CAR T-cell treatments.1 Financial strain not only deters treatment initiation but also contributes to early discontinuation. Expanding insurance coverage, providing financial assistance programs, and streamlining access to patient support resources are vital strategies to alleviate this burden.1 Advocacy for policy changes, such as Medicare coverage for novel therapies, can also enhance affordability.
Geographic Disparities: Rural and remote areas often lack specialized oncology centers, leaving patients with limited access to cutting-edge therapies and clinical trials.1 Telemedicine has emerged as a critical tool in overcoming these geographic barriers, allowing for virtual consultations and follow-ups.2 Additionally, establishing satellite clinics and improving transportation services to tertiary care centers can further bridge this gap.
Systemic Inefficiencies: Delays in diagnosis and treatment initiation can occur due to fragmented care coordination and insufficient provider awareness of evolving therapeutic options. Multidisciplinary tumor boards and streamlined referral pathways can enhance care delivery, ensuring that patients receive timely and appropriate interventions. Continuing medical education (CME) programs for community oncologists can improve familiarity with emerging treatments.
Practicing Cultural Competency: Language differences, health literacy gaps, and cultural beliefs can affect patient engagement and adherence to treatment plans. Employing culturally competent care models, utilizing professional interpreters, and providing educational materials in multiple languages are essential to fostering inclusivity. Additionally, Blue et al. outline five key steps in practicing cultural humility including, “establishing trust, respecting cultural diversity, undergoing cross-cultural training, counseling patients on appropriate available clinical trial options, and connecting patients to community resources.”3
Historically low clinical trial enrollment of minority patients further compounds these existing social and structural inequities.1 For health care professionals managing MM, breaking barriers to care is imperative for improving outcomes. By addressing socioeconomic, geographic, systemic, and cultural challenges, clinicians can ensure equitable access to life-saving treatments and optimize the quality of care for all patients.
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