Is it a chimera? A systematic review of the economic evaluations of CAR-T cell therapy - an update

Expert Rev Pharmacoecon Outcomes Res. 2023 Jul-Dec;23(6):625-650. doi: 10.1080/14737167.2023.2214731. Epub 2023 Jun 19.

Abstract

Introduction: The new class of chimeric antigen receptor T-cell has emboldened health-care professionals and patients for a more effective treatment of hematological malignancies, indicatively lymphoma, acute lymphoblastic leukemia, and myeloma. Nevertheless, their burgeoning procurement costs comprise a litmus stress for health systems across the globe. In this context, this systematic review aims to update the current body of evidence assessing CAR-T economic evaluations and elucidate their financial efficiency.

Areas covered: A systematic review of the economic evaluations of tisagenlecleucel, axicabtagene ciloleucel, idecabtagene vicleucel, lisocabtagene maraleucel, ciltacabtagene autoleucel and brexucabtagene autoleucel was performed.

Expert opinion: The updated results corroborated the previously reported favorable cost-effectiveness ratio of CAR-T. They also pointed out differences among CAR-T agents. However, their budget impact emerges as a significant barrier in the reimbursement process. Any proposed Managed Entry Agreement must integrate the ingrained uncertainty of long-term efficacy and precede reimbursement decisions.

Keywords: CAR-T; KTE-X19; axicabtagene; brexucabtagene autoleucel; ciltacabtagene autoleucel; economic evaluation; idecabtagene vicleucel; lisocabtagene maraleucel; tisagenlecleucel.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Budgets
  • Cell- and Tissue-Based Therapy
  • Cost-Benefit Analysis
  • Humans
  • Immunotherapy, Adoptive
  • Receptors, Chimeric Antigen*

Substances

  • Receptors, Chimeric Antigen