Climate Impact of CAR-T Cell Therapy in the Netherlands: A Comparison on the Use Phase Emission Between Standard of Care and CAR-T Cell Therapy in Hemato-oncology
Author(s)
Max van Wijk, MSc1, Angela Borghouts- de Ruijter, MSc, PharmD2, Roel Freriks, PhD1.
1IQVIA, Amsterdam, Netherlands, 2Gilead Sciences, Amsterdam, Netherlands.
1IQVIA, Amsterdam, Netherlands, 2Gilead Sciences, Amsterdam, Netherlands.
Presentation Documents
OBJECTIVES: This study aimed to quantify the CO2 equivalent (CO2e) emissions from the use phase of Yescarta (axi-cel) and Tecartus (brexu-cel) in the Netherlands, with the goal of understanding their environmental impact within the healthcare sector.
METHODS: The study quantified use-phase CO2e emissions over a 5-year horizon, focusing on healthcare-related activities such as hospitalizations, drug administrations, and patient travel. Survival estimates and the care pathway were based on the published health technology assessment of axi-cel as a second-line treatment for diffuse large B-cell lymphoma (2L DLBCL) in the Netherlands. Additional analyses covered brexu-cel for acute lymphoblastic lymphoma (ALL) and mantle cell lymphoma (MCL). Emissions data were sourced from publicly available, mainly Netherlands specific datasets.
RESULTS: Monthly CO2e emission was higher for patients’ post-progression (27.1 kg CO2e) than for those who were progression-free (20.7 kg). In total, the use phase of axi-cel for 2L DLBCL is associated with 1,251 kg CO2e, compared to 1,175 kg CO2e for the standard of care (SOC). For axi-cel, monitoring visits contributed the most to emissions (40.2%; 503 kg), followed by patient travel (27.6%; 345 kg) and infusion plus hospitalization (25.5%; 319 kg). For SOC, monitoring visits also contributed for 43.2% (541 kg) to the total emission followed by patient travel (21.3%; 267 kg). Comparable findings were observed for brexu-cel in ALL and MCL versus SOC.
CONCLUSIONS: Our findings suggest that healthcare-related activities of axi-cel and brexu-cel are associated with comparable CO2e emissions as SOC. This study focused on the use phase, is limited to a 5-year time horizon, and does not consider subsequent therapies (e.g., 57% of patients received axi-cel after SOC in the ZUMA-7 trial). The SOC’s emissions are likely to be much higher if these factors were considered. A comprehensive life cycle assessment covering all six cradle-to-grave phases is essential to fully understand the total environmental impact.
METHODS: The study quantified use-phase CO2e emissions over a 5-year horizon, focusing on healthcare-related activities such as hospitalizations, drug administrations, and patient travel. Survival estimates and the care pathway were based on the published health technology assessment of axi-cel as a second-line treatment for diffuse large B-cell lymphoma (2L DLBCL) in the Netherlands. Additional analyses covered brexu-cel for acute lymphoblastic lymphoma (ALL) and mantle cell lymphoma (MCL). Emissions data were sourced from publicly available, mainly Netherlands specific datasets.
RESULTS: Monthly CO2e emission was higher for patients’ post-progression (27.1 kg CO2e) than for those who were progression-free (20.7 kg). In total, the use phase of axi-cel for 2L DLBCL is associated with 1,251 kg CO2e, compared to 1,175 kg CO2e for the standard of care (SOC). For axi-cel, monitoring visits contributed the most to emissions (40.2%; 503 kg), followed by patient travel (27.6%; 345 kg) and infusion plus hospitalization (25.5%; 319 kg). For SOC, monitoring visits also contributed for 43.2% (541 kg) to the total emission followed by patient travel (21.3%; 267 kg). Comparable findings were observed for brexu-cel in ALL and MCL versus SOC.
CONCLUSIONS: Our findings suggest that healthcare-related activities of axi-cel and brexu-cel are associated with comparable CO2e emissions as SOC. This study focused on the use phase, is limited to a 5-year time horizon, and does not consider subsequent therapies (e.g., 57% of patients received axi-cel after SOC in the ZUMA-7 trial). The SOC’s emissions are likely to be much higher if these factors were considered. A comprehensive life cycle assessment covering all six cradle-to-grave phases is essential to fully understand the total environmental impact.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE125
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Health Technology Assessment
Topic Subcategory
Novel & Social Elements of Value
Disease
Oncology