CAR-T therapy and historical trends in effectiveness and cost–effectiveness of oncology treatments

Abstract

Aim: This study examines how chimeric antigen receptor T-cell (CAR-T) therapy’s incremental effectiveness and cost–effectiveness profile fits into the recent history of anticancer treatments. Materials & methods: We conducted graphical and multivariable analyses using data from the Cost–Effectiveness Analysis Registry of the Tufts Medical Center and the Institute for Clinical and Economic Review’s analysis of CAR-T therapies. We collected additional information including the US FDA approval years for pharmacologic innovations. Results: CAR-T provided 5.03 (95% CI: 3.88–6.18) more incremental quality-adjusted life-years than the average pharmaceutical intervention and 4.61 (95% CI: 1.67–7.56) more than the average nonpharmaceutical intervention, while retaining similar cost–effectiveness. There was evidence of worsening cost–effectiveness by approval year for pharmaceutical interventions. Limitations: Analysis is limited to anticancer treatments studied in cost–utility analyses, estimated to cover approximately 60% of FDA-approved antineoplastic agents. Conclusion: CAR-T therapy breaks a pattern of stagnant efficacy growth in pharmaceutical innovation and demonstrates significantly greater incremental effectiveness and similar cost–effectiveness to prior innovations.

Cost-Effectiveness of KTE-X19 for Adults with Relapsed/Refractory B-Cell Acute Lymphoblastic Leukemia in the United States

“…While the upfront cost of CAR T-cell therapy is higher than that of current cancer drugs, this novel form of cancer immunotherapy provides increased efficacy driven by their survival advantages. Based on data from the Cost-Effectiveness Analysis Registry of the Tufts Medical Center and the Institute for Clinical and Economic Review’s analysis of CAR-T therapies, CAR-Ts provide significantly greater effectiveness than prior pharmaceutical innovations [ 38 ], providing incremental gains of 5.03 QALYs above the average pharmaceutical intervention, addressing a large unmet in patients. Despite their high up-front costs, the cost-effectiveness of CAR-T therapies has previously been evaluated in other indications and therapy areas.…”

CAR-T Cell Therapy—An Overview of Targets in Gastric Cancer

“…According to the most recent analyses, which were performed with the use of data from the Cost–Effectiveness Analysis Registry of the Tufts Medical Center and the Institute for Clinical and Economic Review’s analysis of CAR-T therapies, CAR-T provided 5.03 (95% CI: 3.88–6.18) more incremental quality-adjusted life-years than the average pharmaceutical intervention, and 4.61 (95% CI: 1.67–7.56) more than the average nonpharmaceutical intervention, while retaining similar cost–effectiveness [ 102 ]. Baumgerdner et al concluded that CAR-T therapy breaks a pattern of stagnant efficacy growth in pharmaceutical innovation and demonstrates significantly greater incremental effectiveness and similar cost-effectiveness to prior innovations [ 102 ]. In the context of GC, no such analyses have been carried out, but the abovementioned results suggest that cost-effectiveness might be similar.…”

Building on Synthetic Immunology and T Cell Engineering: A Brief Journey Through the History of Chimeric Antigen Receptors

“…The success of the anti-CD19 CAR T cell therapy so far clearly indicates the power of immune cell therapy to control leukemia/lymphoma transforming the clinical management of these diseases. CAR T cell therapy demonstrates greater incremental effectiveness and similar cost-effectiveness compared to prior US FDA approved pharmacological innovations 223 . However, great challenges in translating CAR T cell therapy to clinical application remain including the paucity of preclinical models to evaluate safety and efficacy.…”