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Evidence-Based Oncology February 2018
Reimbursement Landscape for Molecular Testing in Non-Small Cell Lung Cancer
Dave Nellesen, PhD; Katerine Dea, MSc; Annie Guerin, MSc; Kenneth W. Culver, MD; Alex Mutebi, PhD; and Anand Dalal, MBA, BSPharm
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Dave Nellesen, PhD; Katerine Dea, MSc; Annie Guerin, MSc; Kenneth W. Culver, MD; Alex Mutebi, PhD; and Anand Dalal, MBA, BSPharm
The Clinical Trial and the Patient's Voice: "I'm Extremely Lucky to Be Alive"
Mary Caffrey
Provocative Questions, Better Biomarkers, and the Prospect of Triple Therapy: A Conversation With NYU's Jeffrey S. Weber, MD, PhD
Mary Caffrey
Recent Approval of Trastuzumab Biosimilar, Ogivri, Has Implications for Patients and Industry
Samantha DiGrande
Currently Reading
With Approval of CAR T-Cell Therapy Comes the Next Challenge: Payer Coverage
Mary Caffrey
Medical World News: Clinical Updates
Medical World News: Clinical/Managed Care Updates
Future Shock: Embracing Disruption in the Immunotherapy Revolution
Joseph Alvarnas, MD

With Approval of CAR T-Cell Therapy Comes the Next Challenge: Payer Coverage

Mary Caffrey
CAR T- cell therapies are among the most expensive ever invented. For now, there’s a lot of uncertainty, as both government and commercial insurers, and a handful of the nation’s leading cancer centers, navigate a reimbursement structure that truly has no precedent.

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References: 
  1. FDA approval brings first gene therapy to the United States [press release]. Silver Spring, MD: FDA Newsroom; August 30, 2017. fda. gov/NewsEvents/Newsroom/PressAnnouncements/ucm574058. htm. Accessed February 7, 2018.
  2. Szabo L. Cascade of costs could push new gene therapy above $1 million per patient. Kaiser Health News website. khn.org/news/ cascade-of-costs-could-push-new-gene-therapy-above-1-million-per- patient/. Published October 17, 2017. Accessed February 9, 2018.
  3. At $475,000 per treatment, is Novartis’ Kymriah a bargain, or just another example of skyrocketing prices? Fierce Pharma website. fiercepharma.com/pharma/at-475-000-per-treatment-novartis- kymriah-a-bargain-or-just-another-example-skyrocketing. Published August 31, 2017. Accessed February 6, 2017.
  4. Kite’s Yescarta (axicabtagene ciloleucel) becomes first CAR T therapy approved by the FDA for the treatment of adult patients with relapsed or refractory large B-cell lymphoma after two or more lines of systemic therapy [press release]. Foster City and Santa Monica, CA: Business Wire; October 18, 2017. gilead.com/news/press-releases/2017/10/ kites-yescarta-axicabtagene-ciloleucel-becomes-first-car-t-therapy- approved-by-the-fda-for-the-treatment-of-adult-patients-with- relapsed-or-refractory-large-bcell-lymphoma-after-two-or-more- lines-of-systemic-therapy. Accessed February 6, 2017.
  5. Miller S. Gene therapy holds great promise, but big price. Express Scripts website. lab.express-scripts.com/lab/insights/drug-options/ gene-therapy-holds-great-promisec-but-big-price. Published September 21, 2017. Accessed February 6, 2018.
  6. Kleutghen P, Mitchell D, Kesselheim AS, Najafzadeh M, Sarpatwari A. Drugs won’t work if people can’t afford them: the high price of tisagenlecleucel [published online February 8, 2018]. Health Aff. 10.1377/hblog20180205.292531.
  7. Welch A. Considerations for CAR T-cell therapy in NHL. OncLive website. onclive.com/web-exclusives/considerations-for-car-tcell-therapy-in-nhl. Published January 19, 2018. Accessed February 9, 2018.
  8. Novartis receives first-ever FDA approval for a CAR T-cell therapy Kymriah (CTL019) for children and young adults with B-cell ALL
    that is refractory or has relapsed at least twice [press release]. Basel, Switzerland: Novartis; August 30, 2017. novartis.com/news/media- releases/novartis-receives-first-ever-fda-approval-car-t-cell-therapy- kymriahtm-ctl019. Accessed February 9, 2018.
 
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