The development of chimeric antigen receptor (CAR) T therapy for patients with advanced hematological malignancies represents one of the greatest successes in bringing basic tumor immunology to the bedside. The ability to potentially cure patients with end-stage acute lymphocytic leukemia (ALL) and diffuse large B-cell non-Hodgkin lymphoma (DLBCL) with a personalized immunotherapy seems science fiction. And yet the rate of uptake of this therapy has been slow, particularly in US Medicare beneficiaries.
At least part of this is related to Medicare’s reimbursement methodology, antiquated for the advent of cell and gene therapies. But this isn’t the only factor holding back access; challenges inherent to the complexity of cell therapy will need to be solved in order to move this forward. Other cell therapies that are in the pipeline will likely be in the same boat, so now is as good a time as any to solve these issues. These solutions will require collaboration of all the stakeholders in the oncology ecosystem.
We have identified three major areas that should be addressed:
- Measuring what matters: recognizing real world value
- Patient flow and practice management: enhancing the patient experience
- Payment policies for cell therapies: acknowledging and fixing Medicare’s shortcomings..