OBJECTIVES: CAR-T-cell therapies showed efficacy for the treatment of various lymphoma subtypes, including DLBCL. The objective of the EpiCART study was to assess the costs of CAR-T-cell-treated DLBCL patients in France.

METHODS: EpiCART is an observational retrospective study performed using the French Nationwide claims database (SNDS), which includes both community and hospital data. All adult patients treated with CAR-T-cells for DLBCL between January 1, 2018 and December 31, 2020 were included. Costs were evaluated in €2022 from the French National Health Insurance’s perspective from 2 months before to 1 year after CAR-T-cell infusion, excluding the cost of CAR-T-cells and using a Bang and Tsiatis model (to account for censored data). Costs of adverse events were defined as the costs of Intensive Care Units 1 year following the discharge post-CAR-T-cell infusion stay.

RESULTS: Over the study period, 528 DLBCL patients received a CAR-T-cell treatment (axicabtagene ciloleucel or tisagenlecleucel). Median (IQR) age was 63.0 (16.2) years and patients were men (61%). Average duration of CAR-T stay was 25.3 (13.3) days, including 7.0 (4.1) days post-infusion. Mean cost of total treatment pathway was €90,957 per patient, including €12,400 in the 2 months prior to the CAR-T-cell stay, €31,494 during the CAR-T-cell stay, and €49,207 in the year following. Cost of adverse events occurring in 157 patients was €25,594 per patient on average.

CONCLUSIONS: Results are consistent with available literature, with a mean cost per patient of €90,957 (excluding CAR-T-cell costs, but including all other patients' costs such as subsequent therapies and EoL costs), representing a total cost of care in line with other severe hemopathies. This must be put into perspective with the subsequent savings inherent to patients with an increased survival/complete remission compared to former standard of care. These results reflect French real-world practices and provide new information on healthcare consumptions outside of the CAR-T-cell stay.