Multidimensional Results and Reflections on CAR-T: The Italian Evidence

Area of Science:

• Health Economics
• Oncology
• Healthcare Management

Background:

• Chimeric antigen receptor T-cell therapy (CAR-T) is an innovative treatment for diffuse large B-cell lymphoma (DLBCL).
• Assessing the economic and organizational impact of CAR-T therapy in Italy is crucial for healthcare sustainability.
• Third-line therapy for DLBCL presents unique challenges for patient management and resource allocation.

Purpose of the Study:

• To define the economic and organizational impacts of CAR-T therapy introduction in Italy for DLBCL patients.
• To assess the sustainability of CAR-T therapy for Italian hospitals and the National Healthcare System (NHS).
• To provide evidence for healthcare decision-makers on resource allocation for innovative treatments.

Main Methods:

• Process mapping and activity-based costing were used to collect hospital costs.
• Analysis focused on CAR-T and Best Salvage Care (BSC) from hospital and NHS perspectives over 36 months.
• Utilized anonymous administrative data from 47 third-line lymphoma patients in two Italian hospitals.

Main Results:

• The Best Salvage Care (BSC) pathway required fewer resources (EUR 29,558.41) compared to CAR-T (EUR 71,220.84, excluding therapy cost).
• CAR-T introduction may increase costs by 15-23% (excluding treatment costs) and requires hospital investments of EUR 15,500-100,897.49.
• CAR-T pathway costs were significantly higher than BSC, highlighting potential economic challenges.

Conclusions:

• CAR-T therapy presents a higher economic burden than BSC for DLBCL management in Italy.
• Significant organizational investments and potential budget increases necessitate careful planning for CAR-T implementation.
• A specific reimbursement tariff is needed to ensure hospital remuneration and manage risks associated with CAR-T therapy.