CAR T-cell therapies, including Novartis’s Kymriah, Gilead / Kite’s Yescarta and Tecartus, and Celgene / Bristol Myers Squibb’s Breyanzi, have given new hope to patients with relapsed/refractory (R/R) non-Hodgkin’s lymphoma (NHL). Additionally, the March 2021 FDA approval of Bluebird Bio / Bristol Myers Squibb’s Abecma (idecabtagene vicleucel) provides the first CAR T-cell therapy for R/R multiple myeloma; FDA approval is also expected for Janssen’s ciltacabtagene autoleucel (cilta-cel) in this indication. We explore how payers approach reimbursement of these expensive new therapies for NHL and multiple myeloma and how reimbursement decisions impact prescribing among surveyed hematologist-oncologists.
Geography: United States.
Primary research: Survey of 100 U.S. hematologist-oncologists; survey of 40 U.S. managed care organization (MCO) pharmacy and medical directors (PDs / MDs).
Fingertip Formulary: National formulary coverage and restrictions data for CAR T-cell therapies by commercial plans covering 161.9 million lives and more than 16 million Medicare Advantage lives.
Key drugs covered: Breyanzi, Kymriah, Tecartus Yescarta, Abecma, ciltacabtagene autoleucel (cilta-cel).
Key analysis provided:
U.S. Access & Reimbursement provides integrated brand- and disease-level insight on reimbursement dynamics and the impact of U.S. payer policy on physician prescribing behavior in the market access environment, including up-to-date analysis of drug coverage and restriction policies and payer and prescriber perspectives on key marketed drugs and receptivity to emerging therapies.