ECONOMIC EVALUATIONS OF CHIMERIC ANTIGEN RECEPTOR T-CELL THERAPIES: A SYSTEMATIC REVIEW...
Author(s)
Yangyang Fan, Bachelor1, Xinyue Yuan, Bachelor1, Pei Wang, Master1, Xiao Ke, PhD2, MING HU, PhD1.
1West China School of Pharmacy, Sichuan University, Chengdu, China, 2Chengdu Kanghong Pharmaceutical Group Co., Ltd, Chengdu, China.
1West China School of Pharmacy, Sichuan University, Chengdu, China, 2Chengdu Kanghong Pharmaceutical Group Co., Ltd, Chengdu, China.
OBJECTIVES: CAR-T therapy has significantly transformed haematological malignanciy treatment. Despite growing cost-effectiveness analyses of CAR-T therapy, systematic reviews on it remain scarce. This study aims to synthesise the existing evidence, summarise methodological and outcome heterogeneity, and informs decision-making.
METHODS: Data were sourced from PubMed, Web of Science, Cochrane Library and the CNKI (January 1998 to April 2026), economic evaluations comparing costs and effects of CAR-T therapy in cancer were included. Quality assessment was performed using the QHES scale. Descriptive statistical analysis was conducted on the results.
RESULTS: A total of 38 studies were included, most studies conducted in the United States. Axicabtagene ciloleucel, tisagenlecleucel, idecabtagene vicleucel, and others were compared either with various standard-of-care chemotherapies or with each other. In terms of perspective, mainly payer perspective (22), healthcare system (11), societal (1), and 4 reported both perspectives.21 studies utilised Partitioned survival model (PSM), six Markov model,2 Discrete Event Simulation,1 decision tree, 1 microsimulation, seven studies included two model types. Most studies adopted a lifetime horizon. Most incremental cost-effectiveness ratio (ICER) ranged from $10,000 to $150,000 per quality-adjusted life-year (QALY). Notably, two US studies reported lower ICER from the societal versus the healthcare system perspective. The willingness-to-pay (WTP) thresholds generally meet or exceed conventional upper limits across countries. 32 studies indicated that the intervention was cost-effective (including 5 with potential cost-effectiveness), while 3 studies were not. Mean QHES score was 89.16 (range 70-100); all but one study were high quality. Deductions were due to missing: perspective rationale, subgroup pre-specification, and bias discussion.
CONCLUSIONS: Current research indicates that the majority of high-quality evidence supports the cost-effectiveness of CAR-T therapy in haematological malignancies. However, limitations in research perspectives persist. The societal perspective (including indirect costs) better captures the cost advantage of one‑time curative CAR‑T therapy over conventional lifelong treatment. Future research should prioritize it.
METHODS: Data were sourced from PubMed, Web of Science, Cochrane Library and the CNKI (January 1998 to April 2026), economic evaluations comparing costs and effects of CAR-T therapy in cancer were included. Quality assessment was performed using the QHES scale. Descriptive statistical analysis was conducted on the results.
RESULTS: A total of 38 studies were included, most studies conducted in the United States. Axicabtagene ciloleucel, tisagenlecleucel, idecabtagene vicleucel, and others were compared either with various standard-of-care chemotherapies or with each other. In terms of perspective, mainly payer perspective (22), healthcare system (11), societal (1), and 4 reported both perspectives.21 studies utilised Partitioned survival model (PSM), six Markov model,2 Discrete Event Simulation,1 decision tree, 1 microsimulation, seven studies included two model types. Most studies adopted a lifetime horizon. Most incremental cost-effectiveness ratio (ICER) ranged from $10,000 to $150,000 per quality-adjusted life-year (QALY). Notably, two US studies reported lower ICER from the societal versus the healthcare system perspective. The willingness-to-pay (WTP) thresholds generally meet or exceed conventional upper limits across countries. 32 studies indicated that the intervention was cost-effective (including 5 with potential cost-effectiveness), while 3 studies were not. Mean QHES score was 89.16 (range 70-100); all but one study were high quality. Deductions were due to missing: perspective rationale, subgroup pre-specification, and bias discussion.
CONCLUSIONS: Current research indicates that the majority of high-quality evidence supports the cost-effectiveness of CAR-T therapy in haematological malignancies. However, limitations in research perspectives persist. The societal perspective (including indirect costs) better captures the cost advantage of one‑time curative CAR‑T therapy over conventional lifelong treatment. Future research should prioritize it.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE55
Topic
Economic Evaluation
Disease
SDC: Oncology