Presentation (CTI)

OBJECTIVES: Chimeric antigen receptor T-cell (CAR-T) therapies have demonstrated considerable clinical benefits in the treatment of multiple myeloma but are associated with high costs. Health-economic analyses indicate that they often fail to achieve cost-effectiveness at current pricing. As their clinical use increases and large numbers of new cellular therapies are developed, innovative strategies are needed to reduce the financial burdens and broaden patient access. The CERTAINTY project is a pioneering initiative aiming to provide a fully integrated virtual twin that can support clinical decision making for CAR-T therapies in multiple myeloma. The objective of our study is to obtain expert estimates on the cost savings potentials of the virtual twin along the CAR-T patient path in an early development phase of the technology.
METHODS: Structured expert elicitation (SEE) has become increasingly important in (early) health technology assessment and economic evaluations - specifically when empirical data is limited or unavailable. Using materials from the structured expert elicitation resources (STEER) repository, aligned with the Medical Research Council (MRC) protocol, elicitation was undertaken with 10 international hematologist-oncologists.
RESULTS: Based on the results of the elicitation, we derive a validated framework that outlines and prioritizes the cost savings potentials of virtual twins for CAR-T therapy along the patient/clinician journey starting from initial diagnosis or relapse all the way to the monitoring stage. Beyond drug cost and administration, the virtual twin should address major cost opportunities such as increasing response rates, reducing out-of-specification CAR T-cell products or preventing adverse events.
CONCLUSIONS: Virtual twins have numerous potentials to improve the cost-effectiveness of CAR-T therapy. Our framework lays important groundwork for the development and design not only of the CERTAINTY virtual twin, but for any future technologies aiming at increasing the cost-effectiveness of CAR-T therapy and thus improving access to cancer therapies worldwide.