Case Studies
Introduction
This case study compendium showcases real-world examples of implementable solutions to address three challenge areas to CAR T-cell therapy mentioned in the report:
- Awareness and understanding of CAR T-cell therapy
- Resources and capacity to deliver CAR T-cell therapy
- Sustainable and innovative financing approaches to manage the costs of treatment and care
Spain: Supporting early identification and referral
Timely identification and referral are an important first step in the patient journey to CAR T-cell therapy. The delivery of CAR T-cell therapy is influenced by both clinical and system factors, which determine whether eligible patients are offered treatment. Recognizing this complexity, the Spanish Ministry of Health published a national Plan for the Approach to […]
US: Identifying patients who are eligible for CAR T-cell therapy
For CAR T-cell therapy, timely identification and referral are important first steps in helping eligible patients get the most out of treatment. However, HCPs, patients and caregivers may be unsure about whether to pursue this type of treatment. Delays in referral could lead to disease progression, making some people ineligible for CAR T-cell therapy.8 In […]
Italy: Addressing regional disparities in access to CAR T-cell therapy
In Italy, access to CAR T-cell therapy is concentrated in a few regions, creating disparities for patients in underserved areas. Challenges driving this include an uneven distribution of authorized treatment centers, shortages of specialist staff and fragmented referral pathways and reimbursement models.137 In 2022, The European House – Ambrosetti, Società Italiana di Leadership e Management in […]
US: Reducing disparities in access to cell therapy
Equitable access to cell therapy (CT) and hematopoietic cell transplantation (HCT) remains a challenge in the US, due to sociodemographic factors, including race and poverty.109 People from underserved groups often face greater obstacles in accessing these treatments.109 To help close these gaps, the American Society for Transplantation and Cellular Therapy (ASTCT) and the National Marrow […]
France: Building capacity beyond CAR T-cell therapy treatment centers
Health system capacity is an important factor in the delivery of CAR T-cell therapy. For example, treatment centers need enough intensive care beds to manage potential treatment-related adverse events and apheresis units must be able to keep up with demand for CAR T-cell therapy to prevent any delays in treatment.6 As indications for CAR T-cell […]
US: Expanding CAR T-cell delivery through satellite models
Access to CAR T-cell therapy is often concentrated in large academic centers in cities, creating logistical barriers for patients who must travel to access treatment.70 To address this, the University of Pennsylvania (UPenn) developed a satellite expansion model to deliver CAR T-cell therapy through a network of affiliated and non-affiliated community hospitals. UPenn manages key […]
US: Supporting community oncology to deliver CAR T-cell therapies
Smaller community cancer programs may refer patients to larger centers for CAR T-cell therapies because of unfamiliarity with the treatment, inadequate reimbursement and infrastructure challenges.71 As a result, access to CAR T-cell therapy is still concentrated in large academic medical centers, creating logistical challenges for patients in rural or underserved areas.70 In 2021, the Association […]
Austria: Expanding equitable access to CAR T-cell therapy
Although CAR T-cell therapy has been available in Austria since 2019, access remained limited, with only a small proportion of eligible patients receiving treatment by 2021.141 Identified barriers included restrictive patient selection criteria, suboptimal referral pathways, and limitations in funding and infrastructure.140 To address these challenges, a national policy initiative was launched by stakeholders from […]