{"id":295553,"date":"2025-10-29T00:00:00","date_gmt":"2025-10-29T00:00:00","guid":{"rendered":"https:\/\/clarivate.com\/life-sciences-healthcare\/report\/acreon0050-2023-biopharma-chimeric-antigen-receptor-car-t-cell-therapy-access-reimbursement-access\/"},"modified":"2026-03-31T10:24:35","modified_gmt":"2026-03-31T10:24:35","slug":"acreon0050-2025-biopharma-chimeric-antigen-receptor-car-t-cell-therapy-access-reimbursement-access-reimbursement","status":"publish","type":"report","link":"https:\/\/clarivate.com\/life-sciences-healthcare\/report\/acreon0050-2025-biopharma-chimeric-antigen-receptor-car-t-cell-therapy-access-reimbursement-access-reimbursement\/","title":{"rendered":"Chimeric Antigen Receptor (CAR) T-Cell Therapy &#8211; Access &#038; Reimbursement &#8211; Access &#038; Reimbursement &#8211; Chimeric Antigen Receptor (CAR) T-Cell Therapy (US)"},"content":{"rendered":"<p>Ever since Novartis\u2019s Kymriah became the first chimeric antigen receptor (CAR) T-cell therapy approved by the FDA for a cancer indication (acute lymphoblastic leukemia) in 2017, this class of drugs has become a key component of treatment of hematological malignancies. Therapies such as Gilead \/ Kite Pharma\u2019s Yescarta and Johnson &#038; Johnson Innovative Medicine\u2019s Carvykti offer hope to patients with relapsed\/refractory (R\/R) non-Hodgkin\u2019s lymphoma (NHL) and patients with R\/R multiple myeloma. However, CAR T-cell therapies\u2019 list prices\u2014some exceeding $400,000 per infusion\u2014create budgetary concerns for payers that may affect treatment decisions. As the market landscape for these novel therapies continues to evolve, we explore how MCO PDs\/MDs approach reimbursement of these expensive therapies for NHL and multiple myeloma and the impact on hematologist-oncologists\u2019 prescribing.<\/p>\n<p><strong>Questions answered <\/strong><\/p>\n<ul class=\"BulletListStyle1 SCXW169638210 BCX0 round-bullets\">\n<li>What factors influence hematologist-oncologists\u2019 choice of a CAR T-cell therapy in second and later lines of treatment?<\/li>\n<li>How do commercial and Medicare Advantage plans reimburse CAR T-cell therapies, and what kind of contracts and payment schemes do MCOs commonly use or hope to use to address these therapies\u2019 high cost?<\/li>\n<li>What prior authorization requirements and other utilization management controls do payers apply to CAR T-cell therapies, and how do these restrictions affect hematologist-oncologists\u2019 prescribing?<\/li>\n<li>How are payers and physicians incorporating other drug classes, particularly bispecific antibodies, into NHL and myeloma treatment? Are payers favoring these lower-cost treatments prior to a CAR T-cell therapy?<\/li>\n<\/ul>\n<div>\n<p><strong>Primary research: s<\/strong>urvey of 100 U.S. hematologist-oncologists, survey of 30 U.S. managed care organization pharmacy and medical directors<\/p>\n<div>\n<p><strong>Fingertip Formulary<\/strong>: Formulary coverage by commercial plans covering more than 165 million lives nationally<\/p>\n<div>\n<p><strong>Real-world data:<\/strong> U.S. pharmacy and medical claims data<\/p>\n<div>\n<p style=\"\"><strong>Key drugs covered:\u00a0<\/strong>Abecma, Breyanzi, Carvykti, Kymriah, Tecartus, and Yescarta<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<p><strong>Product description <\/strong><\/p>\n<p>Leveraging Clarivate\u2019s proprietary data sources and surveys with physicians and payers, Access &#038; Reimbursement provides integrated brand- and disease-level insight on reimbursement dynamics and the impact of payer policy on physician prescribing behavior in the United States. Through detailed analyses of drug coverage, restriction policies, and contracting, as well as payer and prescriber perspectives on key marketed drugs and their receptivity to emerging therapies, this report enables you to:<\/p>\n<ul class=\"BulletListStyle1 SCXW215518153 BCX0 round-bullets\">\n<li>Identify and learn how to overcome roadblocks to market access to best position your brand.<\/li>\n<li>Identify key stakeholders and reimbursement drivers and assess the impact that reimbursement decisions have on treatment selection.<\/li>\n<li>Evaluate competitor strategies for securing favorable market access terms.<\/li>\n<\/ul>\n","protected":false},"template":"","class_list":["post-295553","report","type-report","status-publish","hentry","report-gateway-biopharma","biopharma-therapy-areas-oncology","biopharma-geography-chile","biopharma-geography-us","biopharma-date-2297"],"acf":[],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/report\/295553","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/report"}],"about":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/types\/report"}],"version-history":[{"count":10,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/report\/295553\/revisions"}],"predecessor-version":[{"id":575303,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/report\/295553\/revisions\/575303"}],"wp:attachment":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/media?parent=295553"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}