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

ABSTRACT

Introduction: The new category of chimeric antigen receptor T – cell raised hopes for a more effective treatment of large B cell lymphoma and acute lymphoblastic leukemia. Nevertheless, their soaring acquisition costs will stretch the fiscal capacity of the health systems worldwide. To this direction, the scope of this study is to provide a systematic review of their economic evaluations.

Areas covered: A systematic review of the economic evaluations of tisagenlecleucel and axicabtagene was performed.

Expert opinion: The available data indicate that these products demonstrate a potentially favorable cost-effectiveness ratio. Nevertheless, their budget impact is of overriding importance and it should be incorporated in any economic evaluation. Moreover, more affirmative clinical data are imperative in order to mitigate uncertainty.

KEYWORDS:

• CAR-T
• tisagenlecleucel
• axicabtagene
• economic evaluation

Article Highlights

• A novel category of oncology agents entered the market.

• We performed a systematic review of their economic evaluations in order to elucidate their economic profile.

• The economic evaluations, based on their early clinical data, underpin a potential favorable cost/benefit ratio.

• The extrapolation of survival curves in the modeling is associated with significant uncertainty.

• This comes at a high cost and budget impact should be on the spotlight.

• MEA should be considered and synergies in their administration should be pursued.

Declaration of interest

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.