Using Real-World Evidence in Managed Care Frameworks for the Adoption of Bispecific Antibodies 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

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

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

Real-world evidence is becoming essential for payers, managed care organizations, and value-based care systems when evaluating the utility of bispecific therapies in R/R MM. While clinical trials demonstrate high response rates and progression-free survival, there is a need to validate these findings in broader, real-world populations. Payers seek clarity on how long patients benefit from bispecifics, whether treatment-free intervals are feasible, and how these therapies compare with alternative sequencing strategies in terms of overall survival and time-to-next treatment.

Clinical trial populations often exclude older adults, patients with comorbidities, or those with impaired performance status. This makes postmarketing surveillance and registry data critical to understanding safety profiles, including cytokine release syndrome, neurotoxicity, and infections, especially in underrepresented subgroups such as Black, Hispanic, and older patients. Additionally, resource utilization data is needed to evaluate the broader economic impact—capturing hospital admissions, emergency visits, outpatient infusion demands, and long-term monitoring requirements such as labs and follow-up care.

Cost-effectiveness plays a pivotal role in how bispecifics are positioned on formularies. Payers are actively comparing the total cost of care, quality-adjusted life years, and cost-per-patient-per-month between bispecifics, CAR T-cell therapies, and conventional treatments. There is growing interest in understanding whether bispecifics can serve as more cost-efficient alternatives, potentially delaying or replacing higher-cost options such as CAR T. Insights into treatment discontinuation, patient adherence, and the impact of prior BCMA-directed therapies will also shape value-based contracts and step therapy policies. Ultimately, robust real-world data can guide smarter reimbursement decisions, foster more equitable care access, and optimize how new therapies are integrated into treatment pathways across diverse patient populations.