CAR T-cell therapies (CART) hold out the potential for a paradigm shift in cancer treatment. However, underlying regulatory and manufacturing processes delay hospitals from offering an optimal patient coverage. This study provides an overview of French hospitals regarding CAR T implementation potential and addresses the unmet requirements for a coverage of all French CAR T eligible NHL (Non-Hodgkins Lymphoma) patients.
This study used the PMSI French claim database, which exhaustively lists hospital stays and associated diagnosis, along with a scoring approach applied to main criteria for CAR T hospital eligibility. NHL patient volume was assessed for each hospital and CAR T eligibility was then defined as confirmed NHL with a relapse/refractory disease and non-eligiblility to a Stem Cell Transplantation. The inclusion period was 2015 to 2016. Based on the CAR T implementation guidelines, a score was then attributed to each hospital based on four eligibility criteria: accreditation by the European JACIE committee (score 2); accreditation by the regional health agency for the collection of peripheral Hematopoietic Stem Cells (HSC) (score 1); whether the hospital was referenced by the French Society of Hematology for HSC collection (score 0.5) and for the presence of a leukapheresis unit (score 0.5). “Guidelines from the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC)” Yakoub-Agha I. et al. (2017). DOI: 10.1016/j.bulcan.2017.10.017.
33 out of 948 hospitals with NHL patients have at least one of the eligibility criteria. Eight hospitals cumulate a score ≥ 2.5, considered as the minimum to be able to integrate CAR T technology within the next 2 years. Seven are University Public Hospitals, one is a Public/Private Oncology center. These eight centers cover only 11% from the calculated CAR T-eligible population.
The current gap between the centers qualified to perform CAR T and the actual size of the population eligible for this therapy suggests that significant adaptations might be necessary, which could directly impact the healthcare structure.
IQVIA.
Has not received any funding.
All authors have declared no conflicts of interest.