Large Moderate

Unfortunately, multiple myeloma is still an incurable disease. The therapeutic aim is to reduce tumor burden, alleviate symptoms and prevent relapse and progression as long as possible. In recent clinical trials there has been a growing interest in the measurement of patients ’ health-related quality of life (HRQoL) in addition to the usual end-points such as response, plateau phase duration and survival. In an era with increasing competition for economic resources, there is also a need for cost-utility analysis of new treatment modalities. The Nordic Myeloma Study Group (NMSG) represents more than 100 hospitals in Denmark, Norway and Sweden, covering a population of approximately 15 million. NMSG has integrated HRQoL and pharmacoeconomic evaluations into several recent clinical trials (1-6). We have used the questionnaire developed by the European Organization for Research and Treatment of Cancer (EORTC QLQ-C30), which has been completed prior to treatment and at regular intervals during follow-up by 81-91 % of the patients. HRQoL have been compared to reference data obtained from the Norwegian population, adjusted for age and gender (7). Data on resource consumption have also been recorded prospectively. This is brief summary of what we have learnt: HRQoL of patiens with newly diagnosed multiple myeloma: At diagnosis, myeloma patients have a substantial HRQoL reduction. Figure 1 shows the difference in scale scores between the myeloma patients and the reference population, depicted as effect size (score change/SD) and denoted as small, moderate or large according to conventional criteria. Zero corresponds to the scores of the reference population. The patients report a large reduction of physical and role functioning and moderately impaired social and emotional functioning. Pain and fatigue are substantial problems. Overall, there is a large reduction of the global HRQoL score.-1,