Costs of care during chimeric antigen receptor T-cell therapy in relapsed or refractory B-cell lymphomas.
Mengyang DiKunal C PotnisJessica B LongIris IsufiFrancine FossStuart SeropianCary P GrossScott F HuntingtonPublished in: JNCI cancer spectrum (2024)
High upfront cost may be a barrier to adopting chimeric antigen receptor T-cell (CAR-T) therapy for relapsed or refractory B-cell lymphoma. Data on the real-world costs are limited. Using the Blue Cross Blue Shield Axis database, we evaluated 271 commercially insured patients who received CAR-T therapy for B-cell lymphoma (median age = 58 years; men = 68%; diffuse large B-cell lymphoma = 87%; inpatient CAR-T therapy = 85%). Our peri-CAR-T period of interest was from 41 days before to 154 days after CAR-T therapy index divided into seven 28-day intervals. Median total costs were $608 100 (interquartile range, IQR = $534 100-$732 800); 8.5% of patients had total costs exceeding $1 million. The median cost of CAR-T therapy products was $402 500, and the median out-of-pocket copayment was $510. Monthly costs were highest during the month of CAR-T therapy administration (median = $521 500), with median costs below $25 000 in all other 28-day intervals. Costs of CAR-T therapy use were substantial, largely driven by product acquisition. Future studies should examine the relationship between costs, access, and financial outcomes.
Keyphrases
- diffuse large b cell lymphoma
- epstein barr virus
- acute myeloid leukemia
- healthcare
- palliative care
- end stage renal disease
- mental health
- young adults
- machine learning
- type diabetes
- emergency department
- multiple myeloma
- newly diagnosed
- pain management
- quality improvement
- peritoneal dialysis
- weight loss
- adipose tissue
- hodgkin lymphoma
- middle aged
- electronic health record
- patient reported