Component Costs of CAR-T Therapy in Addition to Treatment Acquisition Costs in Patients with Multiple Myeloma

Sundar Jagannath, Nedra Joseph, Concetta Crivera, Akshay Kharat, Carolyn C. Jackson, Satish Valluri, Patricia Cost, Hilary Phelps, Rafal Slowik, Timothy Klein, Lee Smolen, Xueting Yu, Adam D. Cohen

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Introduction: Ciltacabtagene autoleucel (cilta-cel), is a B-cell maturation antigen-directed, genetically modified autologous chimeric antigen receptor T-cell (CAR-T) immunotherapy. It is indicated for treatment for adult patients with relapsed or refractory multiple myeloma (RRMM) after four or more prior lines of therapy, including a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody. The objective of this study was to estimate the per-patient US commercial healthcare costs related to cilta-cel (CARVYKTI®) CAR-T therapy (i.e., costs separate from cilta-cel therapy acquisition) for patients with RRMM. Methods: US prescribing information for cilta-cel, publicly available data, and published literature were used with clinician input to identify the cost components and unit costs associated with administration of cilta-cel. Cost components included apheresis, bridging therapy, conditioning therapy, administration, and postinfusion monitoring for 1 year of follow-up. Adverse event (AE) management costs for all grades of cytokine release syndrome and neurologic toxicities, and additional AEs grade ≥ 3 occurring in > 5% of patients were included in the analysis. Results: The estimated per-patient average costs of cilta-cel CAR-T therapy administered exclusively in an inpatient setting, excluding cilta-cel therapy acquisition costs, totaled US$160,933 over a 12 month period. Costs assuming different proportions of inpatient/outpatient administration (85%/15% and 70%/30%) were US$158,095 and US$155,257, respectively. Conclusion: Cost estimates from this analysis, which disaggregates CAR-T therapy costs, provide a comprehensive view of the cost components of CAR-T therapy that can help healthcare decision-makers make informed choices regarding the use of cilta-cel. Real-world costs may differ with improved AE prevention and mitigation strategies.

Original languageEnglish
Pages (from-to)263-275
Number of pages13
JournalOncology and Therapy
Volume11
Issue number2
DOIs
StatePublished - Jun 2023

Keywords

  • Chimeric antigen receptor T-cell (CAR-T) therapy
  • Ciltacabtagene autoleucel (cilta-cel)
  • Relapsed/refractory multiple myeloma (RRMM)

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