CAR-T Cost-Effectiveness Similar to Other Regimens

Despite their high price tag, CAR-T regimens were found to be cost-effective compared with other recently approved novel anticancer regimens, according to recent research presented at AMCP Nexus 2018. 

For CAR-T therapies approved by the FDA in 2017—each demonstrating promising long-term outcomes—the costs for these treatments remains exceptionally high. 

“Traditional cost-effectiveness analyses have long been used as the standard for assessing and comparing the value of drugs in oncology,” study author Sarah Whitmire, Ipsos Healthcare, and colleagues explained. “However, despite their high costs, these gene therapies, in addition to several other expensive anti-cancer regimens, have been approved by the FDA and are used in clinical practice today.”

Ms Whitmire and colleagues compared incremental cost-effectiveness ratio estimates performed by the Institute for Clinical and Economic Review (ICER) as a measure of relative value across oncology therapies approved by the FDA in 2017. The research team chose targeted anticancer regimens administered through infusion with an indication for a specific cancer type. Only treatments which had available ICER quality-adjusted life-year (QALY) and life-years gained (LYG) data were included. 

The research team identified eight anti-cancer therapies, including both CAR-T regimens, across eight cancers. Among the identified therapies, three included a pediatric indication for patients younger than 26 years. 

ICER measures ranged from $46,647 per QALY to $791,986 per QALY. Further, incremental QALYs ranged from .64 to 9.18 (mean, 3.85 QALYs gained).

For five anti-cancer therapies, including the CAR-T regimen Kymriah (tisagenlecleucel), cost-effectiveness threshold limits set by the National Institute for Health and Care Excellence (~$125,000 per QALY) and ICER ($150,000 per QALY) were met.

“This study suggests that CAR-T regimens, despite their high price tags, are cost-effective relative to other recently approved novel anti-cancer regimens,” the researchers concluded. “While cost-effectiveness thresholds are valuable, relative cost-effectiveness that more accurately demonstrates willingness to pay may serve as a better model for value assessment.”

—Julie Gould