Chimeric Antigen Receptor (CAR) T-Cell Therapy – Access & Reimbursement – Detailed, Expanded Analysis (US)

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.

Questions Answered

  • What role do CAR T-cell therapies play in the treatment of NHL and multiple myeloma?
  • What are hematologist-oncologists' experiences with the use of Kymriah, Yescarta, and other CAR T-cell therapies so far?
  • What strategies will payers use to control utilization and costs of CAR T-cell therapies as more come to market?
  • What are hematologist-oncologists’ views on select emerging CAR T-cell therapies and other targeted agents in the late-phase pipeline?

Content Highlights

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:​​​​​​

  • ​​​​​​Reimbursement and contracting.
  • Access and prescribing.
  • Opportunities and challenges for emerging therapies.
  • Disease-specific special topic.

Product Description

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.

Table of contents

  • Chimeric Antigen Receptor (CAR) T-Cell Therapy - Access & Reimbursement - Detailed, Expanded Analysis (US)
    • Non-Hodgkins Lymphoma and Multiple Myeloma / U.S. Access & Reimbursement / November 2021