[Multiple myeloma in Argentina: results from a Delphi panel of experts]

In recent decades there have been significant advances in the diagnosis and treatment of multiple myeloma (MM). However, in fragmented health systems such as Argentina's, structural barriers continue to limit equitable access to diagnostic technologies and innovative therapies.

A modified Delphi process including two asynchronous rounds followed by a structured synchronous discussion was conducted to explore expert perspectives on the main barriers affecting MM management in Argentina. Nine expert hematologists with extensive clinical experience, representing different regions of the country and the major health subsectors, participated in the study. The analysis addressed diagnostic, therapeutic, and organizational dimensions of care.

Experts estimated the median overall survival to be approximately 7.8 years, suggesting sustained improvement compared with previous decades. Nevertheless, important inequities persist in access to key diagnostic tools, particularly fluorescence in situ hybridization (FISH) and positron emission tomographycomputed tomography (PET-CT). Marked heterogeneity was also identified in access to innovative therapies, especially anti-CD38 monoclonal antibodies, across the public, social security, and private health subsectors. In addition, the panel highlighted the need for more efficient coverage mechanisms, implementation of a national patient registry, and stronger continuing medical education strategies.

The inequities identified reflect structural weaknesses in Argentina's health system that extend beyond MM itself. Addressing these challenges requires a comprehensive approach that integrates clinical evidence and health economic evaluation into coverage decisions, strengthens diagnostic and therapeutic capacities across levels of care, and promotes innovative financing mechanisms to improve equitable access while preserving system sustainability. This study contributes locally situated expert knowledge, offering a consensusbased foundation to inform policy and support a more equitable and efficient model of MM care.