Achieving Equitable Community CAR T-Cell Access

"Achieving Equitable Community CAR T-Cell Access" closes the series with a look at what happens next.

Dr. Graff predicts the FACT versus non-FACT debate will not resolve quickly, but expects payers and FACT itself will eventually be forced to loosen stringent guidelines as patient volume keeps outpacing accredited capacity. She argues progress requires pharmaceutical companies, physicians, and patients alike to advocate loudly for change, and says the treatment landscape, along with payer and FACT perceptions, will keep evolving.

Dr. Patt notes some states, including Texas, have already passed policy preventing FACT accreditation from serving as a barrier to CAR T coverage, though ERISA governs roughly 80% of payers nationally, limiting state policy's overall reach. She raises the possibility that federal policy could eventually address the gap, and asks what individual practices can do in the meantime. She points to Community Oncology Alliance resources, including standard operating procedure playbooks led by Christine Faft, along with community-access programs from manufacturers like Kite and BMS, and stresses the ongoing need to close educational gaps for patients and caregivers.

Dr. Graff describes her own approach: writing and publishing clinical guidelines, training hospital staff and nurse leaders on her own time, and leaning on peer networks like the Exigent Research Network, where 19 of more than 30 member sites are already building CAR T programs on top of established bispecific infrastructure. She values learning from community peers over academic or pharma perspectives, and credits BMS and Kite for helping address logistical hurdles like apheresis access and just-in-time product delivery for sites without proper storage. Dr. Patt closes by highlighting Texas Oncology's ATTIC council and groups like Integra Connect as additional resources, thanking Dr. Graff for a rich and informative discussion.

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