OBJECTIVES

Investigation and analysis of CAR-T’s market access and reimbursement strategy in China.

METHODS

Literature review of concerned publications from July 2018 to December 2019 was conducted and 38 articles were included. Further in-depth interview for different stakeholders was performed, including health insurance experts, academic researchers, physicians and pharmacists, with a total of 6 visitors. And two advisory board meetings were organized among relevant experts from the medical insurance department, the health department and the hospital management department, with a total of 26 experts participating the seminar. All the materials were compiled for analysis.

RESULTS

1. Commercial health insurance could be applied firstly to build up the CAR-T’s market access and reimbursement strategy, and gradually to touch the public primary medical insurance system in China. A multi-level market access strategy could be set here.
2. Evidence-based health technology assessment (HTA)plays an important role in market access for expensive healthcare program like CAR-T. Enterprises should pay attention to this and provide high-quality evidence and dossier in market access.
3. Due to complicated administration needed for performance-based payment, it could be very hard to implement in China. Instead, budget risk sharing program would be much more feasible in China by negotiating with National Healthcare Security Administration on appropriate price, strict indication, certified hospital and annual budget ceiling, etc.

CONCLUSIONS

Innovative and feasible strategy is essential for CAR-T to get market access in China.