{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T20:17:18Z","timestamp":1793650638521,"version":"4.5.1"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T00:00:00Z","timestamp":1744675200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T00:00:00Z","timestamp":1744675200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Janssen Korea Ltd."}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Blood Res."],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>Given the notable increase in the incidence of multiple myeloma (MM) in Asia and advent of innovative treatments, this study aims to provide a comprehensive understanding of the treatment patterns, outcomes, and economic burden of MM across the lines of therapy (LOTs) in South Korea.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This retrospective cohort study was conducted using data from the National Health Insurance claims data provided by the Health Insurance Review and Assessment Database. An identification algorithm was developed to detect the regimens and LOTs. Treatment patterns and outcomes were assessed as real-world treatment sequence, treatment duration (rwTD), time to next-line treatment (rwTTNT), and overall survival (rwOS). Economic burden was assessed as healthcare resource utilization (HCRU) and the cost incurred per person per month.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>This study included 11,450 patients who were newly diagnosed with MM between January 2010 and December 2019. The observed real-world LOT patterns reflect the changes in South Korea\u2019s reimbursement scheme. Mean treatment-free intervals decreased from 11.59 months (SD 16.23) to 2.77 months (SD 6.14) from the first LOT (LOT 1) to LOT 5. Median rwTTNT decreased from 26.61 months (95% CI: 25.69-27.57) to 12.40 months (95% CI: 11.55-13.49), and median rwOS decreased from 61.88 months (95% CI: 59.11-65.46) to 13.65 months (95% CI: 11.88-16.22). The HCRU and associated costs increased substantially with the LOT advancement.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>This large-scale observational study offers comprehensive insights into the real-world treatment of MM in South Korea. The study findings highlight the progressive nature of MM and increasing economic burden of advanced lines of treatment, underscoring the necessity for optimized treatment strategies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s44313-025-00069-3","type":"journal-article","created":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T07:01:42Z","timestamp":1744700502000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Real-world treatment patterns, outcomes, and economic costs by lines of therapy in patients with newly diagnosed multiple myeloma: a nationwide population-based cohort study in South Korea"],"prefix":"10.1007","volume":"60","author":[{"given":"Sung-Soo","family":"Park","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"YoungJu","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soomin","family":"Yoon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doik","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihyeon","family":"Jeong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kihyun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,15]]},"reference":[{"key":"69_CR1","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1007\/978-3-540-85772-3_2","volume":"183","author":"N Becker","year":"2011","unstructured":"Becker N. Epidemiology of multiple myeloma. Recent Results Cancer Res. 2011;183:25\u201335. https:\/\/doi.org\/10.1007\/978-3-540-85772-3_2.","journal-title":"Recent Results Cancer Res."},{"key":"69_CR2","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1186\/s12885-021-08280-y","volume":"21","author":"L Zhou","year":"2021","unstructured":"Zhou L, Yu Q, Wei G, Wang L, Huang Y, Hu K, Hu Y, Huang H. Measuring the global, regional, and national burden of multiple myeloma from 1990 to 2019. BMC Cancer. 2021;21:606. https:\/\/doi.org\/10.1186\/s12885-021-08280-y.","journal-title":"BMC Cancer."},{"key":"69_CR3","doi-asserted-by":"publisher","first-page":"E359","DOI":"10.1002\/ijc.29210","volume":"136","author":"J Ferlay","year":"2015","unstructured":"Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359\u201386. https:\/\/doi.org\/10.1002\/ijc.29210.","journal-title":"Int J Cancer."},{"key":"69_CR4","doi-asserted-by":"publisher","unstructured":"Lee JH, Lee DS, Lee JJ, Chang YH, Jin JY, Jo DY, Bang SM, Kim HJ, Kim JS, Kim K, Eom HS, Min CK, Yoon SS, Kim SH, Suh C, Cho KS, Korean Multiple Myeloma Working P. Multiple myeloma in Korea: past, present, and future perspectives. Experience of the Korean Multiple Myeloma Working Party. Int J Hematol. 2010;92: 52-7. https:\/\/doi.org\/10.1007\/s12185-010-0617-6","DOI":"10.1007\/s12185-010-0617-6"},{"key":"69_CR5","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1002\/ajh.23731","volume":"89","author":"K Kim","year":"2014","unstructured":"Kim K, Lee JH, Kim JS, Min CK, Yoon SS, Shimizu K, Chou T, Kosugi H, Suzuki K, Chen W, Hou J, Lu J, Huang XJ, Huang SY, Chng WJ, Tan D, Teoh G, Chim CS, Nawarawong W, Siritanaratkul N, Durie BG. Clinical profiles of multiple myeloma in Asia-An Asian Myeloma Network study. Am J Hematol. 2014;89:751\u20136. https:\/\/doi.org\/10.1002\/ajh.23731.","journal-title":"Am J Hematol."},{"key":"69_CR6","doi-asserted-by":"publisher","first-page":"1221","DOI":"10.1001\/jamaoncol.2018.2128","volume":"4","author":"AJ Cowan","year":"2018","unstructured":"Cowan AJ, Allen C, Barac A, Basaleem H, Bensenor I, Curado MP, Foreman K, Gupta R, Harvey J, Hosgood HD, Jakovljevic M, Khader Y, Linn S, Lad D, Mantovani L, Nong VM, Mokdad A, Naghavi M, Postma M, Roshandel G, Shackelford K, Sisay M, Nguyen CT, Tran TT, Xuan BT, Ukwaja KN, Vollset SE, Weiderpass E, Libby EN, Fitzmaurice C. Global Burden of Multiple Myeloma: A Systematic Analysis for the Global Burden of Disease Study 2016. JAMA Oncol. 2018;4:1221\u20137. https:\/\/doi.org\/10.1001\/jamaoncol.2018.2128.","journal-title":"JAMA Oncol."},{"key":"69_CR7","doi-asserted-by":"publisher","unstructured":"Puertas B, Gonzalez-Calle V, Sobejano-Fuertes E, Escalante F, Queizan JA, Barez A, Labrador J, Alonso-Alonso JM, Garcia de Coca A, Cantalapiedra A, Villaescusa T, Aguilar-Franco C, Alejo-Alonso E, Rey-Bua B, Lopez-Corral L, Garcia-Sanz R, Puig N, Gutierrez NC, Mateos MV. Novel Agents as Main Drivers for Continued Improvement in Survival in Multiple Myeloma. Cancers (Basel). 2023;15. https:\/\/doi.org\/10.3390\/cancers15051558","DOI":"10.3390\/cancers15051558"},{"key":"69_CR8","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1186\/s13045-020-00980-5","volume":"13","author":"Y Yang","year":"2020","unstructured":"Yang Y, Li Y, Gu H, Dong M, Cai Z. Emerging agents and regimens for multiple myeloma. J Hematol Oncol. 2020;13:150. https:\/\/doi.org\/10.1186\/s13045-020-00980-5.","journal-title":"J Hematol Oncol."},{"key":"69_CR9","doi-asserted-by":"publisher","unstructured":"Cook R. Economic and clinical impact of multiple myeloma to managed care. J Manag Care Pharm. 2008;14: 19-25. https:\/\/doi.org\/10.18553\/jmcp.2008.14.S7-A.19","DOI":"10.18553\/jmcp.2008.14.S7-A.19"},{"key":"69_CR10","doi-asserted-by":"publisher","first-page":"718","DOI":"10.3346\/jkms.2017.32.5.718","volume":"32","author":"JA Kim","year":"2017","unstructured":"Kim JA, Yoon S, Kim LY, Kim DS. Towards Actualizing the Value Potential of Korea Health Insurance Review and Assessment (HIRA) Data as a Resource for Health Research: Strengths, Limitations, Applications, and Strategies for Optimal Use of HIRA Data. J Korean Med Sci. 2017;32:718\u201328. https:\/\/doi.org\/10.3346\/jkms.2017.32.5.718.","journal-title":"J Korean Med Sci."},{"key":"69_CR11","doi-asserted-by":"publisher","first-page":"503","DOI":"10.2217\/fon-2020-1003","volume":"17","author":"D Madduri","year":"2021","unstructured":"Madduri D, Hagiwara M, Parikh K, Pelletier C, Delea TE, Kee A, Chari A. Real-world treatment patterns, healthcare use and costs in triple-class exposed relapsed and refractory multiple myeloma patients in the USA. Future Oncol. 2021;17:503\u201315. https:\/\/doi.org\/10.2217\/fon-2020-1003.","journal-title":"Future Oncol."},{"key":"69_CR12","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1185\/03007995.2015.1105202","volume":"32","author":"X Song","year":"2016","unstructured":"Song X, Cong Z, Wilson K. Real-world treatment patterns, comorbidities, and disease-related complications in patients with multiple myeloma in the United States. Curr Med Res Opin. 2016;32:95\u2013103. https:\/\/doi.org\/10.1185\/03007995.2015.1105202.","journal-title":"Curr Med Res Opin."},{"key":"69_CR13","unstructured":"Korean Statistical Information System. Korean National Statistical Office. Consumer Price Index. 2020. https:\/\/kostat.go.kr\/incomeNcpi\/cpi\/cpi_td\/2\/3\/index.action?bmode=cpitemper. Accessed 18 Jan 2022."},{"key":"69_CR14","unstructured":"Internal Revenue Service. Annual Average Currency Exchange Rate. https:\/\/www.irs.gov\/ko\/individuals\/international-taxpayers\/yearly-average-currency-exchange-rates. Accessed 18 Jan 2022."},{"key":"69_CR15","unstructured":"National Cancer Center. Annual report of cancer statistics in Korea in 2019. Ministry of Health and Welfare. 2021. https:\/\/www.mohw.go.kr\/upload\/viewer\/skin\/doc.html?fn=1658987991986_20220728145952.pdf&rs=\/upload\/viewer\/result\/202306\/. Accessed 04 Oct 2023."},{"key":"69_CR16","doi-asserted-by":"publisher","first-page":"4885","DOI":"10.1038\/s41598-024-52720-1","volume":"14","author":"S Choi","year":"2024","unstructured":"Choi S, Kim E, Jung J, Park SS, Min CK, Han S. Quantitative risk factor analysis of prior disease condition and socioeconomic status with the multiple myeloma development: nationwide cohort study. Sci Rep. 2024;14:4885. https:\/\/doi.org\/10.1038\/s41598-024-52720-1.","journal-title":"Sci Rep"},{"key":"69_CR17","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1111\/bjh.14213","volume":"175","author":"K Yong","year":"2016","unstructured":"Yong K, Delforge M, Driessen C, Fink L, Flinois A, Gonzalez-McQuire S, Safaei R, Karlin L, Mateos MV, Raab MS, Schoen P, Cavo M. Multiple myeloma: patient outcomes in real-world practice. Br J Haematol. 2016;175:252\u201364. https:\/\/doi.org\/10.1111\/bjh.14213.","journal-title":"Br J Haematol"},{"key":"69_CR18","unstructured":"Health Insurance Review & Assessment Service. Details on the application standards and methods of reimbursement for drugs prescribed and administered to cancer patients. 2022. https:\/\/www.hira.or.kr\/ebooksc\/ebook_702\/ebook_702_202210040427096360.pdf."},{"key":"69_CR19","doi-asserted-by":"publisher","unstructured":"de Moraes Hungria VT, Martinez-Banos DM, Penafiel CR, Miguel CE, Vela-Ojeda J, Remaggi G, Duarte FB, Cao C, Cugliari MS, Santos T, Machnicki G, Fernandez M, Grings M, Ammann EM, Lin JH, Chen YW, Wong YN, Barreyro P. Multiple myeloma treatment patterns and clinical outcomes in the Latin America Haemato-Oncology (HOLA) Observational Study, 2008-2016. Br J Haematol. 2020;188: 383-93. https:\/\/doi.org\/10.1111\/bjh.16124","DOI":"10.1111\/bjh.16124"},{"key":"69_CR20","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s13045-016-0282-1","volume":"9","author":"L Naymagon","year":"2016","unstructured":"Naymagon L, Abdul-Hay M. Novel agents in the treatment of multiple myeloma: a review about the future. J Hematol Oncol. 2016;9:52. https:\/\/doi.org\/10.1186\/s13045-016-0282-1.","journal-title":"J Hematol Oncol"},{"key":"69_CR21","doi-asserted-by":"publisher","first-page":"1915","DOI":"10.1038\/leu.2016.380","volume":"31","author":"R Fonseca","year":"2017","unstructured":"Fonseca R, Abouzaid S, Bonafede M, Cai Q, Parikh K, Cosler L, Richardson P. Trends in overall survival and costs of multiple myeloma, 2000\u20132014. Leukemia. 2017;31:1915\u201321. https:\/\/doi.org\/10.1038\/leu.2016.380.","journal-title":"Leukemia."},{"key":"69_CR22","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1080\/10428194.2019.1648802","volume":"61","author":"M Hagiwara","year":"2020","unstructured":"Hagiwara M, Panjabi S, Delea T, Yucel E, Fonseca R. Burden of disease progression in patients with multiple myeloma in the US. Leuk Lymphoma. 2020;61:47\u201355. https:\/\/doi.org\/10.1080\/10428194.2019.1648802.","journal-title":"Leuk Lymphoma"},{"key":"69_CR23","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1038\/s41408-021-00431-5","volume":"11","author":"R Fonseca","year":"2021","unstructured":"Fonseca R, Hagiwara M, Panjabi S, Yucel E, Buchanan J, Delea T. Economic burden of disease progression among multiple myeloma patients who have received transplant and at least one line of therapy in the US. Blood Cancer J. 2021;11:35. https:\/\/doi.org\/10.1038\/s41408-021-00431-5.","journal-title":"Blood Cancer J"},{"key":"69_CR24","doi-asserted-by":"publisher","first-page":"820","DOI":"10.3904\/kjim.2015.408","volume":"31","author":"J Hong","year":"2016","unstructured":"Hong J, Lee JH. Recent advances in multiple myeloma: a Korean perspective. Korean J Intern Med. 2016;31:820\u201334. https:\/\/doi.org\/10.3904\/kjim.2015.408.","journal-title":"Korean J Intern Med"},{"key":"69_CR25","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1080\/10428194.2020.1827253","volume":"62","author":"M Braunlin","year":"2021","unstructured":"Braunlin M, Belani R, Buchanan J, Wheeling T, Kim C. Trends in the multiple myeloma treatment landscape and survival: a U.S. analysis using 2011\u20132019 oncology clinic electronic health record data. Leuk Lymphoma. 2021;62:377\u201386. https:\/\/doi.org\/10.1080\/10428194.2020.1827253.","journal-title":"Leuk Lymphoma"}],"container-title":["Blood Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s44313-025-00069-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s44313-025-00069-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s44313-025-00069-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T07:01:45Z","timestamp":1744700505000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s44313-025-00069-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,15]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["69"],"URL":"https:\/\/doi.org\/10.1007\/s44313-025-00069-3","relation":{},"ISSN":["2287-979X","2288-0011"],"issn-type":[{"value":"2287-979X","type":"print"},{"value":"2288-0011","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,15]]},"assertion":[{"value":"3 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 March 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 April 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Declarations of human Ethics and Consent to Participate are not applicable to this study, as it was a retrospective, non-interventional study conducted using anonymized structured data. This study was approved by the Institutional Review Boards of the Samsung Medical Center (2022-01-151) and Seoul St. Mary's Hospital (2022-0164). According to applicable legal requirements, this study did not involve any data subject to privacy laws.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare the following potential conflicts of interest: YoungJu Park and Soomin Yoon are employees of Janssen Korea Ltd. Remaining authors have received research grants from Janssen Korea Ltd.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"26"}}