Supporting Managed Care Decisions and Patient Education Around Bispecifics in Multiple Myeloma

EP: 1.Navigating the Complexities of Bispecific Antibody Therapy in Relapsed/Refractory Multiple Myeloma (R/R MM)

EP: 2.Clinical and Practical Comparisons of BCMA-Targeted Therapies in R/R MM

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EP: 3.Supporting Managed Care Decisions and Patient Education Around Bispecifics in Multiple Myeloma

EP: 4.Using Real-World Evidence in Managed Care Frameworks for the Adoption of Bispecific Antibodies in Multiple Myeloma

Guidelines such as those from NCCN provide essential structure for treatment sequencing in R/R MM, particularly regarding novel immunotherapies such as CAR T-cell therapies and bispecific antibodies. While CAR T-cell therapies currently hold a higher placement due to more mature data, bispecifics are gaining ground, especially for patients with significant comorbidities or aggressive disease who are ineligible for CAR T. Institutions are increasingly developing internal pathways that leverage NCCN’s flexibility to tailor sequencing based on evolving clinical data and logistical feasibility.

Although CAR T therapies offer deep and durable responses, their complexity, limited availability, and manufacturing delays restrict accessibility. In contrast, bispecifics can be administered more quickly and flexibly across inpatient and outpatient settings, making them an important option for patients needing immediate intervention. However, questions remain around long-term efficacy, which limits their positioning in guidelines. As a result, real-world data, operational considerations, and institutional infrastructure heavily influence treatment prioritization and sequencing decisions. The 2 modalities are not interchangeable, and each requires individualized consideration based on patient factors and health care system capabilities.

Education is critical for both patients receiving bispecific therapy, and their caregivers, which introduces unique expectations and risks. Patients must understand step-up dosing, the differences between curative and disease control strategies, and how to recognize early symptoms of cytokine release syndrome and neurotoxicity. Clear education around infection prevention, lab monitoring, and supportive care measures such as intravenous immunoglobulin and prophylactic antibiotics is essential. Multilingual resources, multidisciplinary team involvement, and digital tools such as telehealth can enhance understanding and engagement, especially for underserved populations. By equipping patients and caregivers with comprehensive, personalized education, care teams can improve adherence, reduce complications, and ensure continuity of care throughout the bispecific treatment journey.