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EBMT 2023 | Evaluating the cost and benefits of CAR-T therapy

Mohamad Mohty, MD, PhD, Saint-Antoine Hospital, Paris, France, comments on the cost-effectiveness of CAR-T therapy. Prof. Mohty discusses the key role of pharmacoeconomic evaluation in determining the value of this therapy and emphasizes the importance of capturing real-world data in the evaluation of the benefits of CAR-T therapy for patients. This interview took place at the 49th Annual Meeting of the European Group for Blood and Marrow Transplantation (EBMT) held in Paris, France.

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Transcript (edited for clarity)

The community is extremely optimistic and enthusiastic about the advent of CAR T-cells and every day, we see new data, new positive results, and even new labels and approvals. The other side of the coin is about the cost of these new therapies, and this is where the pharmacoeconomic evaluation plays a key role when it comes to introducing these innovations. I personally don’t like the semantic of financial toxicity because actually it doesn’t reflect the reality and the scientific parameters that we need to take into account...

The community is extremely optimistic and enthusiastic about the advent of CAR T-cells and every day, we see new data, new positive results, and even new labels and approvals. The other side of the coin is about the cost of these new therapies, and this is where the pharmacoeconomic evaluation plays a key role when it comes to introducing these innovations. I personally don’t like the semantic of financial toxicity because actually it doesn’t reflect the reality and the scientific parameters that we need to take into account. At the end of the day, it’s about the benefit, risk and the survival improvement. So you cannot have a global bulk like, you know, crude evaluation saying CAR T-cells are expensive or they are cheap or they are this or they are that. In a given indication, with a given construct, with a given price, with a given result, one can evaluate. We do have the scientific tools to do this, the cost effectiveness of these interventions. Once you have done this work, it is more, I would say, a social responsibility to decide how much the society, the payers, the insurers, depending on where you are, is willing to pay for an innovation to improve the survival by this number of months or years. So, you can see it’s not a black and white story. The truth is always in between. But I think this pharmacoeconomic evaluation is crucial and I believe in addition to the prospective trials, we need also to rely and to capture the real world evidence, the real world data in order to generate more information about the benefit of these innovations. This is work in progress. But I remain optimistic because at the end of the day we would like to propose curative treatment. We would like to propose lifesaving treatments to patients with hard-to-treat hematological malignancies and you cannot just simply close the debate by concluding that this is expensive and we cannot afford it. We need to do our homework. We need to do the right evaluation for the right condition, for the right group of patients and I’m sure we will be able to do this in the near future.

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Disclosures

Gilead: Honoraria; GSK: Honoraria; Pfizer,: Honoraria; Adaptive Biotechnologies: Honoraria; Oncopeptides: Honoraria; Astellas: Honoraria; Novartis: Honoraria; Takeda: Honoraria; Amgen: Honoraria; Jazz Pharmaceuticals: Honoraria, Research Funding; Celgene: Honoraria; Bristol Myers Squibb: Honoraria; Sanofi: Honoraria, Research Funding; Janssen: Honoraria, Research Funding.