Improving Patient Access through Value-Based CAR T Delivery: Examples Using a Micro-costing Tool.

Area of Science:

• Health Economics
• Oncology
• Healthcare Management

Background:

• True costs of chimeric antigen receptor T-cell (CAR T) therapy delivery, excluding acquisition expenses, are often uncertain.
• Lack of guidance for cost estimation challenges providers in establishing or expanding CAR T services.
• Inaccurate cost estimations risk inadequate reimbursement, resource issues, and limited patient access to CAR T therapy.

Purpose of the Study:

• To demonstrate a method for value-based CAR T service delivery through accurate cost estimation.
• To introduce an Excel-based micro-costing framework to derive transparent cost estimates for the entire CAR T patient pathway.
• To support providers in developing robust business cases and making informed resourcing decisions for CAR T services.

Main Methods:

• Development of an Excel-based micro-costing framework.
• Inclusion of the full patient pathway, from initial assessment to 100 days post-CAR T infusion.
• Modeling of future scenarios and resource changes to identify efficiencies and improvements.

Main Results:

• The micro-costing tool provides accurate and transparent cost estimates for CAR T delivery.
• It facilitates the identification of opportunities for cost efficiencies and service improvements.
• The tool supports the validation of reimbursement levels and mitigates underpayment risks.

Conclusions:

• Accurate CAR T delivery cost understanding is essential for value-based healthcare and adequate provider compensation.
• The micro-costing tool offers an evidence-driven approach to CAR T program development, reducing reliance on assumptions.
• The tool promotes sustainable CAR T therapy delivery, ensuring provider reimbursement and enhancing patient access.