STOCKHOLM — New drugs and treatment combinations make cure a realistic therapeutic goal for many — but not all — patients with multiple myeloma (MM) in Europe, according to speakers at the European Hematology Association (EHA) 2026 Congress. The reasons for these discrepancies extend beyond patient- and disease-related characteristics, often building on inequities in drug access and availability across European countries. Patient advocates and clinicians discussed these inequalities and their clinical consequences and sought ways to address these issues.

"This session is like another plank in the bridge we are building together with the patient organization and the scientific community," said Barbara Leonardi, president of Myeloma Patients Europe (MPE) and co-chair of the session. Although attendees at congresses like EHA hear about medical breakthroughs and progress in medicine, patients in many countries struggle to access the treatment they need, she told Medscape News Europe. "This is why we are here today."

Two Decades of Progress

Pieter Sonneveld, MD, PhD, professor of hematology at Erasmus MC and University of Rotterdam, provided an overview of the available therapies for MM. Sonneveld, chair of the European Myeloma Network (EMN), highlighted the significant improvements achieved over the past 20 years, including the introduction of anti-CD38 antibodies at different stages of treatment, the use of quadruplets, and the extension of the age limit for transplantation. Moreover, new diagnostic techniques like next-generation sequencing also have been introduced, new staging systems have been built on that information, and minimal residual disease is becoming increasingly important as a highly sensitive outcome to evaluate treatment response and inform prognosis and decisions.

Data show that long-term survival in MM is improving. Five-year relative survival increased from about 30% in the mid-1990s to about 60% around 2020. Mortality is rising more slowly than incidence.

The availability of several new agents has made it increasingly complicated to develop guidelines and to identify the regimen of choice for every patient, Sonneveld noted. "Nonetheless, for clinicians in the field, it's important to have a reference that they can use to make the right choices based on objective data," he added, citing the updated treatment guideline developed in 2025 by EHA and EMN. But guidelines alone may not be enough, because in many countries, the recommended treatments are not available.

Don't Forget the Patient

New therapies have transformed MM from a rapidly progressive, fatal disease into a chronic one. "However, this is not true for many patients in the Central Eastern Europe region," said Snezana Doder, president of the Association of Myeloma Patients Serbia and board member of MPE.

Patient organizations should ask stakeholders for access to new therapies without delay, early diagnosis and screening, and clinical trial participation, said Doder. Patients also should demand governmental accountability, "as MM is not just a matter of health, but also involves finance, social affairs, and more," she said.

Because inequalities are present throughout the patient journey, patients must raise their voices and increase awareness about the disease, the treatments, and the differences in accessing the drugs. "We need to keep talking about it. If we keep quiet, nothing will change," Leonardi told Medscape News Europe. Having many patient organizations work together across local and national borders is pivotal, she added. "MPE serves as an umbrella organization, working directly with the leaders of national patient organizations, covering the entire continent, hearing the voices of different countries, and understanding the differences among them."

The role of the general practitioner is crucial, Leonardi continued. Because MM symptoms are nonspecific and can be attributed to many other nonmalignant conditions, the risk of delayed diagnosis, which allows the disease to progress, is high.

Thinking Outside the Box

Between 2016 and 2026, the EU approved 16 medicines across 34 indications for MM, yet the number of indications included in national reimbursement schemes varies widely from country to country, said Doder. It ranges from 34 in Germany to three in Serbia. The time between market authorization and patient access also differs significantly across Europe: It is 128 days in Germany and 811 days in Serbia, compared with an EU average of 517 days.

These disparities result from factors such as geography, social determinants, and, above all, economic constraints. They must be addressed through a collective effort involving patients and clinicians, as well as local policymakers, national and European regulatory authorities, and Europe as a whole, according to speakers at the session. "Sometimes patients do not even have access to a hospital or to their general practitioner," Doder noted, stressing the crucial role of economic factors. The data show that lack of access is not solely a matter of national wealth, as some high-income countries, such as the Netherlands, still lack access to certain innovative therapies. One reason is that innovative medicines are still viewed primarily as a cost rather than as an investment that could generate long-term savings and improve patients' survival and quality of life.

"A 10-year survival is no longer a dream, and denying access to available treatments effectively means denying patients 10 years of life," Sonneveld said. He identified policymakers as the primary audience for this message. "It is about choice, and they have to change their mindset. This is a decision about patients' lives, not simply about providing a treatment," he told Medscape News Europe.

Leonardi reported no relevant financial relationships. Doder declared that the Association of Myeloma Patients Serbia receives donations and financial support from Janssen, Amicus, Takeda, Hemofarm, and Zentiva. Sonneveld has received research support from BMS/Celgene, Janssen, Karyopharm, and Pfizer. He has participated in advisory boards for BMS/Celgene, GSK, Janssen, Pfizer, Oncopeptides, Regeneron, and Sanofi. His institution has received honoraria from BMS/Celgene, GSK, Janssen, and Pfizer.

Cristina Ferrario is a molecular biologist and former researcher in molecular oncology at three institutes in Milan. She has a master's degree in communication and health from the University of Milan and a master's degree in cancer genetics from the University of Pavia. She has worked as a science journalist for more than 20 years.