New Policy Brief on Value of CAR T-Cell Therapy

December 6, 2019

Chimeric Antigen Receptor T-Cell Therapy (CAR T-cell therapy) is a ground-breaking immunotherapy treatment that takes a patient’s T cells (an immune system cell), adds a special receptor to the T cells—called a chimeric antigen receptor (CAR)—that binds to a certain protein on the patient’s cancer cells, and then administers the CAR T-cells to the patient. These new cells will then attack the patient’s cancer cells.

As promising as CAR T-cell therapy is for people with cancer, patients face significant barriers to access, primarily the high cost of treatment and the limited number of locations where treatment is available.

In response to the concerns that ASCO and other stakeholders have about patient access to CAR T-cell therapy, the society created a new informational policy brief that gives details on specific concerns and outlines the society’s position on approving, covering, and paying for CAR T-cell therapies.

ASCO’s Principles for the Approval, Coverage, and Reimbursement for CAR T-Cell Therapies

ASCO has developed a set of principles on CAR T-cell therapy to help ensure that patients and providers are adequately covered and reimbursed for variable patient care costs and the cost of the treatment itself. When facing a life-threatening diagnosis, it is imperative that patients and providers have financial access to the CAR T-cell therapy, which can ultimately be lifesaving. Some of ASCO’s principles include:

  • ASCO supports coverage for all FDA-approved indications of CAR-T therapy.
  • ASCO supports the delivery of CAR-T therapy in all manufacturer-approved, high-quality health care settings where patients can be safely and effectively treated with this very complex and demanding treatment regimen, including any and all care required for adverse events and follow-up.
  • ASCO believes that Medicare should cover the full cost of CAR-T therapy, with the exception of any applicable patient or provider cost-sharing that would apply to any other covered drug or therapy under the Medicare program.

Read the full policy brief for more information about ASCO’s Principles for CAR-T Cell Therapies.

Visit ASCO in Action for updates efforts to address the high cost of care and breaking cancer policy news.