Operationalizing Access for Chimeric Antigen Receptor T cell Therapies: A Cross-functional Perspective

Area of Science:

• Oncology
• Immunotherapy
• Health Services Research

Background:

• Chimeric antigen receptor T cell (CAR T) therapy offers improved efficacy with timely infusions.
• Treatment delays are linked to increased mortality rates in CAR T therapy.
• Existing healthcare infrastructure, complex treatment pathways, and reimbursement challenges hinder timely patient access.

Purpose of the Study:

• To identify operational barriers contributing to CAR T treatment delays.
• To propose potential solutions for improving timely patient access to CAR T therapy.
• To foster cross-functional cooperation among stakeholders.

Main Methods:

• Convened an expert panel of 6 advisors (3 from transplant centers, 3 from payer organizations).
• Identified operational barriers and potential solutions through expert discussion.
• Focused on treatment center certification, clinical criteria alignment, and financial arrangements.

Main Results:

• Opportunities exist to expand treatment capacity by streamlining center certification and fostering collaboration.
• Aligning clinical criteria can improve clinician understanding and streamline referrals and authorizations.
• Negotiating financial arrangements, including payer contracts and single-case agreements, is critical and time-consuming.

Conclusions:

• Addressing operational barriers and fostering collaboration among stakeholders is essential for timely CAR T access.
• Streamlining processes, aligning criteria, and improving financial negotiations can reduce treatment delays.
• Mutual recognition of interdependence among stakeholders is key to effective cross-functional cooperation.