Challenges raised by the economic evaluation of CAR-T-cell therapies. The review by the French National Authority for Health

Raimond, Véronique; Kaltenbach, Emmanuelle; Adam, Christophe; Lazzarotto, Sébastien; Galès, Catherine Le; Perrier, Lionel; Wittwer, Jérôme

doi:10.1016/j.bulcan.2021.09.001

Cited by 5 publications

(5 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…From an economic perspective, the evaluation of CAR-T is consistent with literature evidence, taking into consideration the setting of the EU-5 (France, Germany, Spain, Italy, and the United Kingdom) and the Netherlands [15][16][17]. A difference emerged concerning the costs related to pre-and post-treatments equal to EUR 50,359 per patient (vs. the value of EUR 70,859.85 calculated in the present study): this difference may be explained due to the integration of the impact of adverse events and to the related economic evaluation.…”

Section: Discussionsupporting

confidence: 67%

“…The mentioned methodologies are normally proposed in the implementation of Health Technology Assessment [23] studies. The implementation of this study design approach could be judged as an aspect of innovation, in comparison to the available literature evidence [15][16][17][41][42][43]. In particular, the HTA approach combines the collection of evidence-based information and original data.…”

Section: Discussionmentioning

confidence: 99%

“…Recent publications reported that public health experts, practitioners and clinicians worldwide called for Clinical Governance (CG) tools to evaluate CAR-T from an economic point of view, using cost-effectiveness criteria and economic forecast concerning the overall budget impact of CAR-T therapies [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Multidimensional Results and Reflections on CAR-T: The Italian Evidence

Foglia

Garagiola

Ladisa³

et al. 2023

IJERPH

View full text Add to dashboard Cite

The present study aims at defining the economic and organizational impacts of the introduction of chimeric antigen receptor T-cell therapy (CAR-T) in Italy, for the management of diffuse large B-cell lymphoma (DLBCL) patients in third-line therapy, defining the overall level of sustainability for both hospitals and the National Healthcare System (NHS). The analysis focused on CAR-T and Best Salvage Care (in the following BSC), assuming the Italian hospital and NHS perspectives, over a 36-month time horizon. Process mapping and activity-based costing methodologies were applied to collect the hospital costs related to the BSC and CAR-T pathways, including adverse event management. Anonymous administrative data on services provided (diagnostic and laboratory examinations, hospitalizations, outpatient procedures, and therapies) to 47 third-line patients with lymphoma, as well as any organizational investments required, were collected, in two different Italian Hospitals. The economic results showed that the BSC clinical pathway required less resources in comparison with CAR-T (excluding the cost related to the therapy) (BSC: 29,558.41 vs. CAR-T: EUR 71,220.84, −58.5%). The budget impact analysis depicts that the introduction of CAR-T would generate an increase in costs ranging from 15% to 23%, without considering treatment costs. The assessment of the organizational impact reveals that the introduction of CAR-T therapy would require additional investments equal to a minimum of EUR 15,500 to a maximum of EUR 100,897.49, from the hospital perspective. Results show new economic evidence for healthcare decision makers, to optimize the appropriateness of resource allocation. The present analysis suggests the need to introduce a specific reimbursement tariff, both at the hospital and at NHS levels, since no consensus exists, at least in the Italian setting, concerning the proper remuneration for the hospitals who guarantee this innovative pathway, assuming high risks related to timely management of adverse events.

show abstract

Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Multidimensional Results and Reflections on CAR-T: The Italian Evidence

Foglia

Garagiola

Ladisa³

et al. 2023

IJERPH

View full text Add to dashboard Cite

show abstract

“…Previous studies have been limited to cost-effectiveness analyses based on listed drug prices or have used algorithms or proxies as estimates for cost. [17][18][19][20][21] There are also multiple studies investigating the cost of CAR-T therapy delivery in other countries' health systems, [22][23][24][25][26][27][28][29] however studies of comprehensive real-life cost of cellular therapy for pediatric B-ALL are not available in the US.…”

Section: Introductionmentioning

confidence: 99%

Healthcare Cost and Utilization for Chimeric Antigen Receptor (CAR) T-Cell Therapy in the Treatment of Pediatric Acute Lymphoblastic Leukemia: A Commercial Insurance Claims Database Analysis

Hoover,

Reimche,

Watson

et al. 2023

Preprint

View full text Add to dashboard Cite

BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common malignancy of childhood. With the introduction of novel cellular therapies, cost of care is a critical component and financial toxicity experienced by patients and society requires evaluation. This study aims to assess the total cost of CAR-T therapy for pediatric ALL patients with commercial insurance coverage in the United States. STUDY DESIGN: Using de-identified commercial insurance data from the OptumLabs Data Warehouse, a cohort of 37 patients, aged 1-25 years, with B-ALL treated with CAR-T therapy between Oct 2016 and Dec 2021 in the United States was identified. Cost was evaluated for a 90 day period encompassing CAR-T infusion and by administration and complication characteristics. RESULTS: Among the 37 identified ALL patients that received a CAR-T product infusion, 14 patients were female, median age at administration was 13 years. The median 90-day total cost was $620,500 (Mean: $589,108). Inpatient cost accounted for approximately 71% of the total cost with an average of 28 inpatient days per patient. Although inpatient cost was slightly higher in the older age group (aged 10-25 years) and in patients with a code for CRS, these differences were not statistically significant. CONCLUSION: This real-world cost analysis shows for the first time the encompassing cost of CAR-T therapy for pediatric ALL patients in the US with commercial insurance. This study provides a valuable benchmark that can be used to analyze the financial implications of CAR-T therapy for pediatric ALL therapy on health systems.

show abstract

mentioning

confidence: 99%

Healthcare cost and utilization for chimeric antigen receptor (CAR) T‐cell therapy in the treatment of pediatric acute lymphoblastic leukemia: A commercial insurance claims database analysis

Hoover,

Reimche,

Watson

et al. 2024

Cancer Reports

View full text Add to dashboard Cite

BackgroundB‐lineage acute lymphoblastic leukemia (B‐ALL) is the most common malignancy of childhood. With the introduction of novel cellular therapies, cost of care is a critical component and the financial burden experienced by patients and society requires evaluation.AimsThis study aims to assess the utilization and cost of care for chimeric antigen receptor T‐cell (CAR‐T) therapy for pediatric ALL patients with commercial insurance coverage in the United States.Methods and ResultsUsing de‐identified commercial insurance data from the OptumLabs® Data Warehouse, a cohort of 37 patients, aged 1‐25 years, with B‐ALL treated with CAR‐T therapy between Oct 2016 and Dec 2021 in the United States was identified. Cost was evaluated for a 90 day period encompassing CAR‐T infusion and by administration and complication characteristics. Among the 37 identified B‐ALL patients that received a CAR‐T product infusion, 14 patients were female, median age at administration was 13 years. The median 90‐day total cost was $620,500 (Mean: $589,108). Inpatient cost accounted for approximately 71% of the total cost with an average of 28 inpatient days per patient. Although inpatient cost was slightly higher in the older age group (aged 10‐25 years) and in patients with a code for cytokine release syndrome (CRS), these differences were not statistically significant.ConclusionThis real‐world cost analysis shows for the first time the encompassing cost of CAR‐T therapy for pediatric B‐ALL patients in the US with commercial insurance. This study provides a valuable benchmark that can be used to analyze the financial implications of CAR‐T therapy for pediatric B‐ALL therapy on health systems.

show abstract

Challenges raised by the economic evaluation of CAR-T-cell therapies. The review by the French National Authority for Health

Cited by 5 publications

References 18 publications

Multidimensional Results and Reflections on CAR-T: The Italian Evidence

Multidimensional Results and Reflections on CAR-T: The Italian Evidence

Healthcare Cost and Utilization for Chimeric Antigen Receptor (CAR) T-Cell Therapy in the Treatment of Pediatric Acute Lymphoblastic Leukemia: A Commercial Insurance Claims Database Analysis

Healthcare cost and utilization for chimeric antigen receptor (CAR) T‐cell therapy in the treatment of pediatric acute lymphoblastic leukemia: A commercial insurance claims database analysis

Contact Info

Product

Resources

About