War in the Blood: The battle takes shape in the burgeoning European oncology CAR-T market access space

With the continuing evolution of the CAR-T landscape, Research Partnership speaks to payers across Europe to investigate the market access and commercialisation potential for manufacturers of these exciting, in theory, one-shot personalised therapies.

I have a vivid memory of watching War in the Blood, a 2019 feature-length BBC documentary about CAR-T cell therapy and the potentially revolutionary impact on the landscape of cancer treatment. The filmmakers followed two leukaemia patients in first-in-human trials in the UK. CAR-T was showcased as their only hope and a way to re-programme the immune system to kill cancers. As with any clinical trial, questions arose. In this case, key questions centred around the long-term safety and effectiveness of the personalised CAR-T, due to its potential curative intent.

As more CAR-Ts have obtained marketing authorisation in the intervening years, similar questions have also been on the minds of payers and policymakers making decisions about how – and in which patient populations – to pay for this new modality, whose upfront cost and theoretically one-time administration is difficult to assess in the same way as traditional drugs.

In this article, Research Partnership reviews the market access opportunities and challenges encountered by CAR-Ts commercialised in the EU-4 and the UK (see Tables 1 and 2). To complement our review, we reached out to 12 payers in our network with advanced therapy expertise from across the UK, France, Germany, Spain, and Italy. We discuss their feedback and the ramifications below. We also share select findings from our new syndicated tool Access CGT, a cell and gene therapy analogue access and policy tracker.

• Read the full article in pharmaphorum's Deep Dive digital magazine