EHFG Session ‘CAR-T: The evolution of a revolution?’ (F9)


Day 2 of the #EHFG2019 concluded with a session about the current hype in cell therapy – CAR-Ts! Many aspects were discussed from R&D, manufacturing, logistics, infrastructure, delivery, patient access and reimbursement schemes. While all speakers, ranging from oncologists, patients, industry and payers agreed how fantastic this hope-bringing innovation is, one important aspect of the debate was not given the attention it deserves – fair pricing of such innovative cancer treatments. 

There is no doubt CAR T-cells provide hope to the hopeless with no alternative options. However, the current list price for Novartis’ Kymriah is €320,000 (excl. VAT) per patient. Kymriah has been on the European market for about a year and it seems to be about 50% successful in the short-term. German payers recently noted they are paying 5% of their drug budget for 0.007% of the population. This excludes the investments that need to be made to ensure quality of the medical facilities, properly trained work force and addressing serious side-effects caused by the drug’s toxicity.

So, why are CAR-Ts so expensive? Everyone knows prices are not always based on the spending for research and development. After all, CAR-T research was heavily funded by public investment. Is it the cost of manufacturing? Hardly, academics can now cook their own CAR-Ts in the labs. Is it value? Perhaps. No one can argue with that, especially when we do not know what is the value of life, especially for paediatric patients. The problem with current pricing models is that they are based on speculations of how much is the system willing to pay.

So, what would be a fair price for CAR-Ts? There is no universal definition of a fair price understood by all stakeholders, but everyone agrees that fair price might not necessarily be the cheapest price as it needs to generate enough revenue to stimulate research. Currently, the average return on investment for cancer medicines is over 14 USD on each invested buck. Maybe this fair price equation should contain an ethical aspect too.

This Blog was written by the Young Gasteiner Anna Prokupková

Interested in reading more about CAR-Ts? Click here.


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