SITE-OF-CARE PATTERNS IN DLBCL: EVIDENCE OF DISTRIBUTED ONCOLOGY CARE PATHWAYS IN THE US AND IMPLICATIONS FOR CAR-T DELIVERY IN EUROPE
Author(s)
Ekaterina Ponomareva, PhD1, Maxine Diehl, BS2, AJ Schlossler, BS3, Raghav Goyal, BS4, SHAILJA PANDEY, BS4, Sri Saikumar, MBA2.
1Associate Director RWE Analytics, Trinity Life Sciences, Princeton, NJ, USA, 2Trinity Life Sciences, Waltham, MA, USA, 3Trinity Life Sciences, New York, NY, USA, 4Trinity Life Sciences, Bangalore, India.
1Associate Director RWE Analytics, Trinity Life Sciences, Princeton, NJ, USA, 2Trinity Life Sciences, Waltham, MA, USA, 3Trinity Life Sciences, New York, NY, USA, 4Trinity Life Sciences, Bangalore, India.
OBJECTIVES: Since its approval in 2017/18 (US/EU), CAR‑T treatment has been highly centralized, with administration primarily performed at accredited academic centers. However, broader oncology care, including lymphoma diagnosis, treatment coordination, and follow‑up, is delivered across outpatient and community settings within networked care pathways. This analysis assessed site‑of‑care patterns for DLBCL in U.S. claims data and evaluated care delivery beyond academic centers to inform how distributed pathways may operate in European systems.
METHODS: We analyzed ~23,000 DLBCL US patients diagnosed between July 2023 and June 2025 using Komodo open and closed claims. Treating sites were classified as academic (n=191) or community centers (n=2,297) using Definitive Healthcare affiliations. Site‑of‑care patterns, CAR‑T utilization, and referral dynamics were assessed. Secondary research contextualized findings within European oncology care models.
RESULTS: In U.S. claims data, 70% of DLBCL patients were treated exclusively in community centers, 23% in academic centers, and 7% across both settings. On average, community centers treated 10 patients and academic centers 38; among centers administering CAR‑T, these increased to 33 and 62, respectively. Within two years of diagnosis, 3% of patients received CAR‑T, 43% of whom were treated in community centers. Referrals were limited (16%) and less likely to involve academic vs community centers among CAR‑T recipients. Secondary research indicates that, in Europe, CAR‑T delivery is embedded within primarily academic centers, while lymphoma care overall similarly includes community centers.
CONCLUSIONS: U.S. data suggests advanced lymphoma care increasingly involves community centers which enables broader access to treatments like CAR-T. Although CAR‑T administration remains centralized in Europe, oncology care pathways are similarly distributed across settings, with community centers acting as coordinators within networked systems. Strengthening referral networks and shared‑care models may be as important as expanding treatment capacity to improve access in Europe, as is already being done in the US.
METHODS: We analyzed ~23,000 DLBCL US patients diagnosed between July 2023 and June 2025 using Komodo open and closed claims. Treating sites were classified as academic (n=191) or community centers (n=2,297) using Definitive Healthcare affiliations. Site‑of‑care patterns, CAR‑T utilization, and referral dynamics were assessed. Secondary research contextualized findings within European oncology care models.
RESULTS: In U.S. claims data, 70% of DLBCL patients were treated exclusively in community centers, 23% in academic centers, and 7% across both settings. On average, community centers treated 10 patients and academic centers 38; among centers administering CAR‑T, these increased to 33 and 62, respectively. Within two years of diagnosis, 3% of patients received CAR‑T, 43% of whom were treated in community centers. Referrals were limited (16%) and less likely to involve academic vs community centers among CAR‑T recipients. Secondary research indicates that, in Europe, CAR‑T delivery is embedded within primarily academic centers, while lymphoma care overall similarly includes community centers.
CONCLUSIONS: U.S. data suggests advanced lymphoma care increasingly involves community centers which enables broader access to treatments like CAR-T. Although CAR‑T administration remains centralized in Europe, oncology care pathways are similarly distributed across settings, with community centers acting as coordinators within networked systems. Strengthening referral networks and shared‑care models may be as important as expanding treatment capacity to improve access in Europe, as is already being done in the US.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HSD41
Topic
Health Service Delivery & Process of Care, Organizational Practices, Real World Data & Information Systems
Disease
Oncology