Unlocking Access: Operationalizing CAR T-Cell Therapy in the Community

Key Takeaways

• Community-based CAR-T programs require defined roles for coordinators, pharmacy, nursing, and on-call coverage to manage apheresis, product tracking, and CRS/ICANS monitoring.
• Partnerships with tertiary centers can enable shared protocols, rapid escalation pathways, and co-management models that keep routine care local while ensuring specialty backup.
• Financial planning must address payer contracting, prior authorization workflows, and mitigation of reimbursement lag relative to high upfront product and hospitalization costs.
• Site-of-care decisions should align with toxicity risk, bed capacity, and outpatient infrastructure to optimize safety while reducing avoidable inpatient utilization and cost.