ISSUE: The introduction of two chimeric antigen receptor therapies (CAR-Ts) in 2017 ushered a new era of transformational medicine in oncology. These treatments, typically administered in the inpatient setting, involve engineering a patient’s own immune cells to treat the cancer. While CAR-Ts have shown complete responses and prolonged disease-free survival in a substantial proportion of patients with refractory B cell malignancies in clinical trials, a large portion of patients even in high- and middle-income countries do not currently receive CAR-Ts due to multiple access barriers. At the same time, there are over 400 CAR-Ts in development with several companies working towards next-generation CAR-Ts, including those addressing cancers with high prevalence. Hence, concerns about payer affordability are likely to arise as patient access and availability of CAR-Ts is poised to increase in the coming years. 

OVERVIEW: This issue panel will present a global perspective of patients, providers, payers, and manufacturers and debate the key access and affordability issues surrounding CAR-Ts and potential strategies to overcome these barriers. Sachin Kamal-Bahl will provide a brief overview of the current landscape and moderate the panel by posing the following questions to the panelists: What are the current access barriers to CAR-Ts? Can we better understand the unique access barriers to CAR-Ts from the varying perspectives on the panel and identify mid- to long-term practical solutions to address these barriers? What about payer affordability issues that will come along with expanded access? How can we strike a balance between these competing issues and foster life-saving innovation? Ellen Miller Sonet will address these questions from the patient perspective. Scott Huntington, an oncologist and health policy researcher focused on access and affordability issues, will represent both the health care system and payer perspective. Indranil Bagchi will present the perspective of a CAR-T pharmaceutical manufacturer in the debate.
"