Epidemiology Overview: With a rising burden in older adults and higher incidence in males, tailored approaches to screening and treatment are essential for improving outcomes

Accounting for 17% of all haematological malignancies, multiple myeloma is seen as a major hem-onc indication, i.e., with higher prevalence being reported in males Vs females. The median age of diagnosis is 70. Younger patients present a lower ISS (International Staging System) stage and have better treatment outcomes. The older patient population have less favourable prognostic factors.

United States in Focus:

In 2025, American Cancer Society estimated 36,110 new multiple myeloma cases with a projected death pool of 12,030.  The probability of developing multiple myeloma in males is 0.9% in males Vs to that of 0.8% in females. 65+ years age group is most prone to the disease. 

Incidence by Age

Age standardised incidence rate per 100,000 is highest in 65-85+ age group. This indicates a need of drugs with high safety profile. This population is suspectable to deteriorating age and often faces comorbidities.

Incidence by Sex
Incidence is higher in males Vs females, i.e., across all age groups. In males the incidence is 16.3%+ Vs females, indicating a need of regular check in males.

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Driver: The Growing Burden of Multiple Myeloma in an Aging World

With growing geriatric population, multiple myeloma is expected to increase. In Europe, the overall incidence rate is 2.8 per 100,000 in 2022. On average, people are diagnosed at around 69 years of age. By age, incidence was highest reported in 65-85+ (22.3%), 35-64 (4.0%), 0-34 (0.03%). Europe also reports a higher prevalence in males (3.4%) Vs females (2.3%).  

This age-related pattern takes on greater significance considering rapid global aging. By 2030, one in six people worldwide will be over the age of 60, a figure projected to double to 2.1 billion by 2050. As a result, the number of older adults diagnosed with multiple myeloma is expected to rise by nearly 80% in the next two decades. This demographic transformation has far-reaching implications for healthcare infrastructure and treatment delivery. 

Older patients often present with added complexities such as frailty, organ impairment, and comorbidities, factors that complicate both diagnosis and therapeutic decision-making. These challenges underscore the need for individualized and age-adapted strategies that prioritize early detection, supportive care, and geriatric-sensitive treatment regimens. 

To meet this rising burden, healthcare systems must respond proactively. Investments in targeted research, expanded access to care, and development of integrated, patient-centric models will be critical to ensuring improved outcomes for multiple myeloma patients - particularly within the growing elderly population.

Challenges: The Financial Burden of Advanced Multiple Myeloma Treatments 

Advanced treatments for multiple myeloma, including CAR T-cell therapies and bispecific antibodies, are bringing new hope to patients with relapsed or refractory disease. However, these breakthroughs come with a heavy financial burden. Bispecific antibodies like Tecvayli, Elrexfio, and Talvey have significantly raised the cost of care. For example, Tecvayli is priced at around USD 29,608 for the first 28 days and USD 26,964 for each cycle thereafter. CAR T-cell therapies are even more expensive. Abecma, idecabtagene vicleucel, approved in the US for patients who have received at least two prior lines of therapy, costs around USD 419,500, while Carvykti, ciltacabtagene autoleucel is priced at approximately USD 465,000 for relapsed refractory multiple myeloma patients. This coupled with limited CART centres further make the situation worrisome. As of July 2024, CAR T-cell therapies were available only at 311 certified centres across the US, meaning patients may need to travel long distances, adding further financial and logistical strain.  

Insurance coverage does provide some relief, but challenges remain. While private insurance is often linked to better access and improved outcomes, patients on public programs like Medicare frequently face restricted access and coverage gaps. Reimbursement processes are complex, and out-of-pocket expenses can still be overwhelming. Studies have shown that 55% of insured multiple myeloma patients report financial hardship, highlighting financial toxicity where the cost of treatment itself leads to stress and reduced adherence. 

While advanced therapies are transforming outcomes in multiple myeloma, their cost is creating serious barriers, making access uneven and treatment sustainability a growing concern for patients and healthcare systems alike. 

Opportunities: CAR T-Cells and Bispecific Antibodies Redefining Treatment Potential
 
The treatment landscape of multiple myeloma (MM) is evolving with major advancements in CAR T-cell therapies and bispecific antibodies, offering significant opportunities. CAR T-cell therapies like idecabtagene vicleucel and ciltacabtagene autoleucel have demonstrated impressive response rates in relapsed/refractory patients, achieving overall responses of 73-98%. However, relapse remains a significant challenge, as nearly all patients experience it, with around 50% relapsing within 26.9 months. The opportunity lies in improving the durability of CAR T-cells and combining them with other therapies for longer-lasting remissions. However, they are not off-the shelf. 
 
Bispecific antibodies targeting BCMA and GPRC5D present promising off-the-shelf alternatives to CAR T-cell therapy, with response rates above 60% (teclistamab ) in patients with refractory MM. Despite their potential, issues like toxicity and antigen escape need to be addressed. Combining bispecific antibodies with other therapies could improve efficacy, particularly for advanced-stage MM. 

By Drug Class: IMiDs and PIs Dominate Frontline and RRMM Settings, While Cellular and Bispecific Therapies Redefine Later Lines

The global multiple myeloma market by drug class is segmented into alkylating agents, proteasome inhibitors, immunomodulatory drugs (IMiDs), monoclonal antibodies (mAbs), nuclear export inhibitors, corticosteroids, histone deacetylase (HDAC) inhibitors, anti-body drug conjugate, bispecific T-cell engager, and CAR T-cell therapy. 

The market is currently led by IMiDs and proteasome inhibitors, which together form the backbone of treatment in both frontline and relapsed/refractory settings. The selection of an appropriate treatment strategy is multifactorial, influenced by the patient's disease stage, prior treatment history, and overall health status. Among IMiDs, agents such as lenalidomide, thalidomide, and pomalidomide continue to dominate the market. Lenalidomide (Revlimid) is a popular choice for the treatment of multiple myeloma. It is marketed by Bristol Myers Squibb and generated $5.77 billion in total revenues in 2024, i.e., across indications including multiple myeloma. Despite the entry of generics such as Teva’s lenalidomide, supported by co-pay assistance programs in the United States, the branded version retains a significant market share due to its well-established role in both newly diagnosed and maintenance settings. Pomalidomide, often used in combination with low-dose dexamethasone, is a critical treatment option for patients with relapsed or refractory multiple myeloma (RRMM), especially those resistant to lenalidomide and bortezomib. 

Proteasome inhibitors (PIs) also account for a substantial portion of the market. Bortezomib (Velcade), the first-in-class PI approved in 2003, remains integral to frontline regimens such as VRd (bortezomib, lenalidomide, dexamethasone). Carfilzomib (Kyprolis), approved in 2012, is associated with deeper responses and is primarily used in relapsed settings due to its higher cost and cardiovascular toxicity profile. Ixazomib (Ninlaro), the first oral PI, gained popularity during and after the COVID-19 pandemic owing to its convenience and ability to reduce hospital visits, making it a preferred option for maintenance therapy. 

Corticosteroids like dexamethasone and prednisone serve as essential adjuncts across treatment regimens, enhancing the efficacy of primary agents and aiding in the management of inflammation, nausea, and pain through their immunosuppressive action.

While IMiDs, proteasome inhibitors, and corticosteroids remain the mainstay of treatment, newer drug classes are steadily expanding their role. HDAC inhibitors like panobinostat (Farydak) offer a novel epigenetic approach but are largely limited to heavily pre-treated patients due to toxicity concerns. Among the most promising advancements is the rise of bispecific antibodies. Teclistamab (Tecvayli), the first approved bispecific targeting CD3 and BCMA, has shown deep and durable responses in patients with multiple prior therapies, with trials now exploring its use earlier in the treatment pathway. 

Additionally, CAR-T cell therapies such as idecabtagene vicleucel (Abecma) and ciltacabtagene autoleucel (Carvykti) have revolutionized the treatment landscape for heavily pre-treated patients by offering personalized, single-infusion options that deliver profound and lasting remissions.

The multiple myeloma treatment landscape is becoming increasingly diverse and personalized, with therapies targeting distinct disease mechanisms.

By Disease Stage: Relapsed/Refractory Stages leads the market followed by Newly Diagnosed 

The multiple myeloma (MM) treatment landscape is evolving rapidly due to clinical advances, better diagnostics, and heightened disease awareness. The market is divided into Newly Diagnosed Multiple Myeloma (NDMM) and Relapsed/Refractory Multiple Myeloma (RRMM), each with distinct clinical needs and opportunities.
NDMM treatment typically includes induction regimens like bortezomib, lenalidomide, and dexamethasone (VRd), followed by autologous stem cell transplant (ASCT) and maintenance therapy. Treatment strategies are influenced by patient age, transplant eligibility, and cytogenetic risk. The global incidence of multiple myeloma was 148,754 new cases in 2021.

RRMM dominates the therapeutic market, driven by patients progressing through multiple lines of therapy. The rise in refractory cases boosts the market value, particularly with next-generation treatments like CAR T-cell therapies such as ide-cel and cilta-cel, and Carvykti (cilta-cel) priced at $465,000 per patient. Premium monoclonal antibodies like isatuximab, priced at $3,789 for a 30 mL (500 mg/25 mL) IV injection, also significantly contribute to revenue generation.

By Dosage Form: Oral Lead, Followed by Injectables 

The multiple myeloma treatment market is increasingly shaped by two dosage forms oral and parental. Oral formulations (tablets and capsules) lead the market with a combined share of more than 50%. Oral route offers flexibility in complex treatment plans and higher patient adherence to regimen. Injectables includes high-cost monoclonal antibodies and CARTs, typically administered intravenously. These are not seen as frontline therapies and are reserved for later stage patients.

By Distribution Channel: Offline channels lead the market while online expand ease in access 

The distribution landscape for multiple myeloma (MM) treatments spans two primary channels: offline channels (hospital pharmacies & retail specialty pharmacies) and online pharmacies. Offline channel encompassing hospital and retail speciality pharmacies remain the main stays for dispensing multiple myeloma drugs. The segment is estimated to acquire ~80% of the market share. It will maintain its leadership during the forecast period.  

Online pharmacies are emerging as a rapidly growing channel. Driven by the demand for convenience and digital health tools, they offer home delivery, price transparency, and educational resources, positioning themselves for continued growth in the MM treatment space during the forecast.

As multiple myeloma care moves toward decentralization, integrating these channels will be key to improving patient adherence, reducing treatment disruptions, and ensuring optimal outcomes. Seamless collaboration among healthcare providers, payers, and pharmacies will drive this integration, ultimately enhancing the patient experience.

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By Geography: North America Leads, While Asia-Pacific and Emerging Markets Propel the Future Growth of the Multiple Myeloma Market

The global multiple myeloma market is geographically segmented into North America, Europe, Asia-Pacific, South America, and the Middle East & Africa, each exhibiting distinct growth patterns and market dynamics. 

North America holds the dominant share of the global market, primarily driven by the high multiple myeloma incidence, robust healthcare infrastructure, and early adoption of advanced treatments. The age standardised incidence rate in US and Canada are 4.8% and 5.3%, respectively. This followed by increasing Medicare spending is favourable for market growth. In 2021 Medicare part D covered 63.4 million people Vs to that of 52.4 million in 2013.  The region also has a strong pharmaceutical manufacturing landscape, with major players like Johnson & Johnson, Amgen, and Bristol Myers Squibb investing heavily in R&D and clinical trials. Moreover, patient advocacy groups and pharma companies’ education also create awareness for multiple myeloma. 

Europe continues to maintain a strong presence in the multiple myeloma market, driven by developed healthcare systems and significant EU-funded oncology research. Key markets such as Germany, the UK, and France are experiencing rising incidence and mortality. However, high drug cost and longer regulatory approval processes compared to the United States is a restraint for the market growth. 

The Asia-Pacific region is the fastest-growing market segment, fuelled by improving awareness, and expanding access to novel therapies. In China, the crude prevalence of multiple myeloma stands at 6.88 per 100,000, with an incidence rate of 1.60 per 100,000 person-years, signalling a significant treatment demand. Japan and India are witnessing an increase in clinical trials and product launches.  In Japan, Sarclisa (isatuximab) got approved by the Ministry of Health, Labour and Welfare in February 2025. 

The Middle East & Africa holds the least share of multiple myeloma market owing to regional disparities and poor healthcare ecosystem in African countries. Regional leaders here include major GCC countries particularly KSA, UAE, and South Africa. 

Recent Developments

April 28, 2025: Regeneron’s Lynozyfic (linvoseltamab) Receives EU Approval for Refractory Multiple Myeloma
The European Commission granted conditional approval to Lynozyfic for adults with relapsed/refractory multiple myeloma. Lynozyfic is the first BCMA-CD3 therapy that can be dosed every 4 weeks. The approval is based on LINKER-MM1 trial. The trail showed that Lynozyfic can produce 71% response rate and 50% complete response or better, with a 29-month median duration of response.

Mar 17, 2025: AstraZeneca Acquires EsoBiotec for Up to $1B ($425M upfront, $575M in milestones)
EsoBiotec has a lentiviral vector platform that supports off-the-shelf cell therapies via. This acquisitions adds to AstraZeneca’s cell therapy portfolio, including its $1.2B Gracell deal in 2023. 

Feb 12, 2025: Opna Bio’s OPN-6602 Receives Orphan Drug Designation for Multiple Myeloma
Opna Bio announced that its oral EP300/CBP bromodomain inhibitor, OPN-6602, has received FDA Orphan Drug Designation for the treatment of relapsed/refractory multiple myeloma. OPN-6602, is in Phase I trail.

Dec 9, 2024: GSK Reports 42% Reduction in Death Risk with Blenrep Combo in Multiple Myeloma
GSK’s Blenrep, in combination with bortezomib and dexamethasone, reduced the risk of death by 42% in patients with relapsed/refractory multiple myeloma, per interim results from the DREAMM-7 trial.
Patients on the Blenrep combo are projected to live nearly 3 years longer, compared to standard care. GSK has refiled for FDA approval, with a decision expected by July 2025, and received priority review in China. The drug, once pulled from the US market, is now being positioned for a comeback, with a projected USD 3.99B+ peak sales potential.

Key Competitors

• Takeda Pharmaceutical Company Limited
• Mylan N.V.
• Novartis AG
• Teva Pharmaceutical Industries Ltd.
• Bristol Myers Squibb Company
• Arcellx
• Regeneron Pharmaceuticals, Inc.
• Cartesian Therapeutics
• BeiGene
• AbbVie Inc.
• Roche (F. Hoffmann-La Roche Ltd)
• Amgen Inc.
• Ono Pharmaceuticals
• Janssen Pharmaceuticals, Inc.
• Genentech, Inc. (a subsidiary of Roche)
• Celgene Corporation (part of Bristol Myers Squibb)
• Sanofi
• Karyopharm Therapeutics Inc.
• Others

Global Multiple Myeloma Treatment Market Segmentation

By Drug Class:

• Alkylating Agent
  • Melphalan (generic)
  • Cyclophosphamide (generic)
  • Bendamustine (Treanda)
  • Melphalan flufenamide (meflufen; Pepaxto)
• Proteasome Inhibitors
  • Bortezomib (Velcade)
  • Carfilzomib (Kyprolis)
  • Ixazomib (Ninlaro)
• Immunomodulatory Drugs (IMiDs)
  • Thalidomide (Thalidomid/generic)
  • Lenalidomide (Revlimid)
  • Pomalidomide (Pomalyst/Imnovid)
• Monoclonal Antibodies
  • Daratumumab (Darzalex)
  • Isatuximab (Sarclisa)
  • Elotuzumab (Empliciti)
• Nuclear Export Inhibitors
  • Selinexor (Xpovio)
• Antibody Drug Conjugate (Blenrep)
• CAR T Cell
  • Idecabtagene vicleucel (ide-cel; Abecma)
  • Ciltacabtagene autoleucel (cilta-cel; Carvykti)
• Steroids
  • Prednisone (generic)
  • Dexamethasone (generic)
• Chemotherapy
• Histone Deacetylase (HDAC) Inhibitors
  • Panobinostat (Farydak)
• Bispecific Antibodies
  • Teclistamab-cqyv (Tecvayl)
  • Elranatamab-bcmm (Elrexfio)
  • Linvoseltamab (Lynozyfic)
  • Talquetamab-tgvs (Talvey)

By Disease Stage:

• Newly Diagnosed
• Relapsed/Refractory

By Dosage Form:

• Oral
• Injectables
• Others

By Distribution Channel:

• Offline Channel
  • Hospital Pharmacies
  • Speciality Retail Pharmacies
• Online Pharmacies

By Geography   

• North America  
  • The USA  
  • Canada  
  • Mexico  
• Europe  
  • Western Europe  
    • The UK  
    • Germany  
    • France  
    • Italy  
    • Spain  
    • Rest of Western Europe  
  • Eastern Europe  
    • Poland  
    • Russia  
    • Rest of Eastern Europe  
• Asia Pacific  
  • China  
  • India  
  • Japan  
  • Australia & New Zealand  
  • South Korea  
  • ASEAN  
  • Rest of Asia Pacific  
• Middle East & Africa  
  • Saudi Arabia  
  • South Africa  
  • UAE  
  • Rest of MEA  
• South America   
  • Argentina  
  • Brazil  
  • Rest of South America