Presentation (CTI)

OBJECTIVES: To develop a patient flow model that estimates how changing from in-patient to ambulatory patient care for CAR T therapy might affect treatment centre cost, resource use and capacity for adult patients with R/R B-ALL, from a UK National Health Service (NHS) perspective.
METHODS: A patient flow model, based on operations research methods, was developed in Microsoft Excel to consider the full patient pathway from initial assessment through to approximately 100 days post-administration. The model is divided into pre-, within-, and post-treatment phases and comprises 28 stages. The model estimates costs as well as resource constraints including staff time and bed capacity at each stage.
RESULTS: Given the heterogeneity of UK CAR T centres, the model is a user-modifiable tool that can be adjusted to reflect individual treatment centres, including bed availability, allocated staff hours and ambulatory patient monitoring capabilities. The model allows users to explore the benefit of increasing ambulatory patient delivery for CAR T therapy for patients meeting outpatient eligibility criteria. The tool's flexibility allows providers to model different potential future scenarios, including fully ambulatory patient care (excluding leukapheresis and inpatient admissions for adverse event management), and ambulatory patient care from defined periods after CAR T administration.
CONCLUSIONS: By providing cost, resource use and capacity estimates, the patient flow model facilitates an evidence-based approach to decision-making in CAR T therapy delivery in the UK with potential applications including business case development for introducing ambulatory care into CAR T centres. The model supports efficient CAR T therapy delivery, with the ultimate aim of facilitating patient access to the potential benefits of CAR T therapy.