Real-world healthcare costs for patients treated with chimeric antigen receptor T-cell therapy in Canada

Chimeric antigen receptor T-cell (CAR-T) therapy is a practice changing high-cost therapy; however, little is known about the real-world cost of CAR-T. We estimated the acute healthcare costs associated with CAR-T for patients with r/r DLBCL. We performed a retrospective cohort study of patients who received CAR-T between 1 January 2020 and 31 August 2021 at Princess Margaret Cancer Center, Toronto, Ontario. Costs were divided into distinct costing phases. Mean total costs per phase and by service category were calculated. Fifty-three patients received CAR-T. The mean age was 61 years and the majority were male (60%). The total mean costs per patient were: C$11,180 (95% CI: $7712-14,649) for the pretreatment phase (30 days), C$511,983 (average product cost C$473,127) (95% CI: $504,472-520,666) for the treatment phase, and C$41,620 (95% CI: $29,935-52,933) for the post-treatment phase (100 days). This cost information may inform cost-effectiveness analyses for CAR-T as well as reimbursement decisions.